Abstract
Diagnosis and treatment of adolescent mild traumatic brain injury (mTBI) are explained based on the 4th Edition Guidelines for Diagnosis and Treatment of Traumatic Brain Injury revised October 1st, 2019. Diagnosis of mTBI remained unchanged. GCS score of 13 to 15 is diagnosed as mTBI. Concussion defined as functional brain damage is not the same as mTBI defined as organic brain damage. Concussion recognition tool 5 is useful to diagnose concussion in the sports field.
Treatment of mTBI should be based on triage using the Japan Triage and Acuity Scale 2017. To reduce the chance of deterioration in the general condition, primary survey and secondary survey are recommended using the Japan Advanced Trauma Evaluation and CareTM. Secondary survey of mTBI is based on plain brain CT. The criteria for brain CT did not change from 3rd edition. Post-concussion syndrome is diagnosed using the International Statistical Classification of Diseases and Related Health Problems 10 or Diagnostic and Statistical Manual of Mental Disorders 4. Hyperbaric oxygen therapy may be useful for the treatment of post-concussion syndrome. Repeated concussion may lead to chronic traumatic encephalopathy. Higher-order brain dysfunction may occur after mTBI.
A period of rest after mTBI is recommended before returning to the previous occupation or school.
