Before diving into the details of treating the symptoms or co-occurring conditions that may accompany concussion, here are a few principles to guide you.
First Guiding Principle: Take a Thorough Clinical History
This is probably the single most important thing you can do. Here is a checklist that asks about previous brain injuries with some questions you can ask.
- What was the service member's health like before this concussion? For example, was this her first ever (military or civilian) concussion?
- Did he have headaches before the trauma?
- Did the service member have a history of substance abuse or psychological issues including stress before the injury?
- Does the service member have a history of learning disabilities or attention deficit disorder?
If the service member had headaches or psychological issues prior to this concussion, he or she has a greater likelihood of having persistent problems after the injury. While it's helpful to understand which symptoms are likely related to one or more recent concussions, it's even more important to treat the presenting symptoms because if untreated, these symptoms can become significant problems.
Nurse practitioner Helen Coronel explains why it's so important to understand which symptoms are new versus pre-existing:
Getting a Thorough History Is the Necessary Starting Point for Patients with TBI
Sometimes, problems don't seem obvious until the service member is back home. Changing routines and environments can highlight symptoms that might have been overlooked in the deployed setting.
Adam Anicich talks about going back to work and realizing that something was different: