Mixed messages from the 'Mild Traumatic Brain Injury' and 'Sport-related Concussion' literatures: Clinical implications.

Objectives

The Sport-related Concussion (SRC) literature has three areas of emphasis which in some circumstances can be detrimental to the recovery of a patient after a mild traumatic brain injury (MTBI). These include the role of organic factors in post-concussion symptoms, the need to be asymptomatic to return to play and the later-life complications of sustaining multiple MTBIs. These contrast with quite different emphases in the broader MTBI literature and can cause significant anxiety for some patients with prolonged post-concussion symptoms (PCS).

Methods

This paper presents for the first time a case where such factors operated.

Results

Five sessions of cognitive-behavioural therapy (CBT) to address these elements resulted in the complete amelioration of persisting PCS.

Conclusions

Anxiety due to maladaptive cognitions influenced by the 'mixed messages' from the SRC literature can exacerbate or solely maintain persisting PCS but may be successfully addressed with CBT.