A Survey of Neurologists on Postconcussion Syndrome
Conflict of Interest: None.
Background and Objectives
Postconcussion syndrome (PCS) has been controversial for more than 150 years. As there have not been any surveys of PCS among neurologists in the United States since 1992, another was performed using most of the prior items to assess current opinions and practices and whether there have been any changes since 1992.
Two hundred and eighty-nine neurologists attending the Texas Neurological Society 20th Annual Winter Conference continuing medical education meeting in 2017 were supplied the survey instrument with registration materials. The 25 item instrument (including 7 new items) contained items on demographics, definitions, causation, prognosis, medicolegal aspects, testing, and treatment. Forty percent of attendees completed the survey.
The majority of respondents agree with the following: PCS is a clearly defined syndrome with a solid basis for determining prognosis with an organic basis; accept the authenticity of patients' reports of symptoms; effective treatment is available for headaches lasting 3 months or more; headaches persist in over 20% 1 year after injury; and cognitive rehabilitation is effective. The majority of the respondents do not agree with the following: symptoms improve in a relatively short period of time and quickly resolve once litigation is settled; effective treatment is available for PCS; and return to play guidelines are strongly evidence based. 68.4% disagree with the following: I would support my son or grandson (or if you do not have one, relative's or friend's) playing football. [Correction added on February 9, 2018, after first online publication: “One year after injury” deleted.]
There has been growing acceptance of the organicity of PCS among neurologists in the last 25 years. There is significant concern over the long-term sequelae of concussion as most respondents would not recommend that their son or grandson play football.