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

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.

• Concussion
• head injury
• mild brain injury
• post-concussion syndrome
• traumatic brain injury

Acknowledgements

We thank the ACSM for kindly providing the list of physician members. We also thank the physicians at Nationwide Children’s Hospital who participated in face-validation of the survey and pilot runs to look for technical difficulties.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.