Citation

Bevilacqua ZW. Front. Neurol. 2024; 15: e1362702.

Copyright

(Copyright © 2024, Frontiers Research Foundation)

DOI

10.3389/fneur.2024.1362702

PMID

38504797

PMCID

PMC10948499

Abstract

Concussion, or mild traumatic brain injury, is not uniformly defined. Recent consensus describes concussion as a sport or exercise-related injury that perturbs neurotransmitter, metabolic, and axonal homeostasis (1). Other descriptions are more narrow in scope, specifying the signs and symptoms that must emerge following forceful trauma to the head (2). Iterative definitions of concussion are informed by impactful research, spurring new characteristics such as the utility of cerebral hemodynamics and functional magnetic resonance imaging in detecting abnormalities (1).

Generally, concussion is portrayed as an injury that imposes disabling sequela, however, the label of "disability" remains associated with the diagnoses of moderate and severe forms of traumatic brain injury (TBI) in published works (3, 4). Suspectedly, this is due to the brief, "mild" nature of concussion, with other disability diagnoses like severe TBI and attention deficit disorder representing lengthy or permanent impairments. While concussion was once thought to resolve in ≤ 2 and ≤ 4 weeks for adults and children, respectively (5), recent appraisal now indicates that a concise timeframe for recovery is difficult to determine (1). Regardless of its duration, concussion is a debilitating injury that is accompanied by a myriad of symptoms and functional impairments which substantially interrupt daily living. For instance, damage to vestibular and ocular connections can present obstacles when driving or engaging in school or work activities, whereas dysregulated cerebral blood flow will make basic activities difficult or uncomfortable. Deficiencies like these align with the Americans with Disabilities Act (ADA) definition of disability (6), and call into question why this or similar terms have not been woven into the mild TBI conversation. Accordingly, this article aims to begin the conversation by educating practitioners on why concussion is classified as a temporary disability, and more importantly, why interdisciplinary teams should consider using this language when managing concussion.

Language: en

Keywords

504 accommodation plan; college and university students; concussion; disability; patient care; return to learn (RTL) services