How long is too long? The lack of consensus regarding the post-concussion syndrome diagnosis

Brain Inj. 2015;29(7-8):798-803. doi: 10.3109/02699052.2015.1004756. Epub 2015 Apr 14.

Abstract

Background/aim: A standard definition of Post-concussion Syndrome (PCS) does not exist. The objective was to determine consensus regarding the definition of PCS among physician members of the American College of Sports Medicine (ACSM).

Methods: Physician members of the ACSM were sent an electronic survey to determine opinions regarding the PCS diagnosis.

Results: Five hundred and ninety-seven physicians completed the survey. When asked the minimum duration of symptoms required to diagnose PCS, respondents answered: <2 weeks (26.6%), 2 weeks to 1 month (20.4%), 1-3 months (33%) and >3 months (11.1%). Physicians who see ≥10% concussion patients in their practise, as well as physicians whose concussion population consists of >50% paediatric patients, were more likely to require >1 month of symptoms (p < 0.001). When asked the minimum number of symptoms required to diagnose PCS, responses varied: one symptom (55.9%), two symptoms (17.6%), three symptoms (14.6%) and four or more symptoms (3.2%). Respondents from the US were more likely than non-US respondents to require only one symptom for the PCS diagnosis (p = 0.01).

Conclusions: There is a lack of consensus regarding the definition of PCS among physician members of the ACSM. A standard definition would improve consistency in concussion research and in clinical practise.

Keywords: Concussion; head injury; mild brain injury; post-concussion syndrome; traumatic brain injury.

MeSH terms

  • Athletic Injuries / complications
  • Athletic Injuries / diagnosis*
  • Consensus
  • Diagnostic and Statistical Manual of Mental Disorders
  • Health Surveys
  • Humans
  • International Classification of Diseases
  • Post-Concussion Syndrome / diagnosis*
  • Post-Concussion Syndrome / etiology
  • Prognosis
  • Recovery of Function
  • Sports Medicine*
  • Time Factors
  • United States / epidemiology