This edition of Brain Injury Professional on “Best Practices in Concussion Management” was edited by Wesley Cole, PhD, and Emma Cole, PhD.
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Message from Guest Editors
Over the past 20 years the military conflicts in Iraq and Afghanistan and an increased awareness in athletics has resulted in an explosion of concussion research. There have been over 7 times as many scholarly articles published on concussion versus the prior 20 years (i.e., 1980-2000) as well as a significant increase in broader awareness from coverage of concussion in mainstream news and sports media, or popular media portrayals (e.g., the movie “Concussion” from 2015). Though there have been significant strides in the way we evaluate and manage concussion, we still have a lot to learn. In fact, as you’ll see in Silverberg and Iverson’s article, we’re still refining the definition of concussion.
The ever growing body of research and the remaining gaps in our knowledge make it difficult for even the most experienced concussion providers to stay “up-to-date” on best practices. Therefore, we sought out leaders in the field of concussion for this edition, to help bring you up to speed on current concussion best practices and the future of concussion research. The feature article by Brody provides an overview of the standard of care for concussion. He uses the clever analogy of making and delivering a pizza to discuss how patients require an individualized, yet comprehensive approach to their care (go ahead and give in to your inevitable craving and place your pizza order now). Finkel and Ahrens summarize best practices for the management of posttraumatic headache, often the most prevalent and persistent post-concussive symptom.
Articles by McKinney as well as Svingos and Suskauer review recent advances in clinical recommendations for military and pediatric populations, respectively. And in looking forward, Bell and Matthews discuss how technology can improve concussion care, and McCrea and Manley review the current state of diagnostic and prognostic objective biomarkers for concussion. Finally, we are delighted to present the expert interview of Dr. Risa Nakase-Richardson, conducted by Dr. Theresa Woo of the National Intrepid Center for Excellence. Dr. Nakase-Richardson is the Project Director for the VA healthcare systems arm of the DoD and VA’s “15-year TBI study.” Here she discusses current findings of that study and what we can expect in the future from this incredibly valuable research effort.
We appreciate the editors in chief for giving space to discussing current best practices in concussion care. We acknowledge this is not a comprehensive review of all topics related to concussion. Of note, we don’t venture into the long-term outcomes of concussion or repeated head traumas, including topics related to neurodegenerative disease (e.g., CTE); for more information on chronic conditions, we direct you to volume 16, issue 3 of Brain Injury Professional. Regardless, we hope the content helps advance your knowledge of concussion management and sets the stage for your continued learning, as the field will continue to advance at lightning speed. The views expressed herein are those of the author(s) and do not necessarily reflect the official policy of the Department of the Army, Defense Health Agency, Department of Defense, or the US Government.