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Military- and Sports-Related Mild Traumatic Brain Injury: Clinical Presentation, Management, and Long-Term Consequences

J Clin Psychiatry 2013;74(2):180-188

Awareness that concussions are more serious than previously believed has been increasing. Also known as mild traumatic brain injury (mTBI), concussions often occur, and often multiple times, in both military and sports settings. Brain injuries can seriously and negatively impact patients, leading to changes in personality, sleep problems, and cognitive impairments and can increase the risk for suicide, posttraumatic stress disorder, depression, and anxiety. In some people, repetitive mTBI can lead to chronic traumatic encephalopathy (CTE), a neurodegenerative disorder. Evidence-based treatments are needed for both mTBI and CTE. Currently, symptom management and education are the best strategies to help those who have received multiple concussions. Prevention education about concussions and the use of return-to-play guidelines are especially important for young athletes.

From the Veterans Affairs (VA) Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC); Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine; and the University of Washington Alzheimer’s Disease Research Center, Seattle (Dr Peskind); Department of Neurology, Washington University School of Medicine, St. Louis, Missouri (Dr Brody); Military and Veterans’ Clinical Rehabilitation Research, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada (Dr Cernak); Departments of Neurology and Pathology, VA Boston, and the Center for the Study of Traumatic Encephalopathy and the Alzheimer’s Disease Center, Boston University, Boston, Massachusetts (Dr McKee); and Neurology Service, Cleveland VA Medical Center, Cleveland, Ohio (Dr Ruff).