Concussion Diagnosis, Management, and Functional Recovery: An Interdisciplinary and Evidence-Based Approach

Sport-related concussion is a common and clinically complex form of mild traumatic brain injury with significant academic, occupational, and psychosocial consequences. Management has shifted away from prolonged strict rest to early, symptom-limited activity and targeted rehabilitation. Concussion remains a clinical diagnosis, and routine neuroimaging is typically normal. Symptoms may evolve over hours to days, and structured tools support early assessment; however, they should not be used in isolation to determine recovery or clearance. Office-based evaluation facilitates comprehensive assessment of symptom domains, comorbidities, and functional impact, and subsymptom threshold aerobic exercise testing provides a guide for early activity and individualized progression. Management includes therapies targeted to specific symptom patterns and interdisciplinary care for persistent symptoms. Pharmacologic therapy is symptom targeted and supportive, with limited evidence for select interventions and recommended avoidance of sedating agents that can confound monitoring. Nutritional and dietary supplements have theoretical benefit but insufficient clinical evidence for routine use. Functional recovery is addressed through individualized plans for return to learn, return to play, and return to drive. Prevention should focus on evidence-based risk reduction, with strongest support for policy and rule changes, and equipment and training interventions provide variable benefit. Emerging technologies are primarily research tools given limited standardization and uncertain clinical thresholds.