Physiatric management of mild traumatic brain injury

Mild traumatic brain injury (MTBI) is a common condition, afflicting as man y as 1.5 million Americans yearly. Most individuals sustain MTBI as a resul t of motor vehicle collisions, but it may also occur as a result of falls, physical assault or sporting accidents. Problems related to MTBI include va rious pain syndromes, cognitive impairments, disorders of affect, cranial n erve dysfunction, and vertigo, arising from injury to the brain, head, or c ervical spine. Symptoms are usually transient, although a small percentage of afflicted individuals develop long-lasting problems, often preventing th em from leading productive lives. Recognition of these problems as arising from MTBI is difficult due to the frequent lack of abnormal findings on dia gnostic tests and failure to identify a history of head trauma. The America n Congress of Rehabilitation Medicine has defined MTBI, an important first step in identifying individuals who need treatment. Diagnosis is usually ma de by directed questions regarding trauma history and careful procurement a nd interpretation of appropriate tests. Once a diagnosis is made, proper ca re can be prescribed in order to lead patients toward more productive lives .