Consider this scenario: A patient comes in complaining of vision problems following a concussion, also known as mild traumatic brain injury (TBI). Do you know the key questions to ask this patient to determine whether further eye or vision evaluation and care is needed?
Defense and Veterans Brain Injury Center (DVBIC) offers primary care providers clinical support tools to assess and manage patients with concussion. For example, a quick reference card on visual dysfunction addresses “red flag” symptoms that need urgent referral to appropriate specialists, and “yellow flag” symptoms that are considered less severe but still require a referral to an eye specialist or neurologist.
While the majority of patients with mild TBI recover quickly (in one to three months) with minimal intervention, some develop lingering symptoms that interfere with social and occupational functioning. More than likely these patients will see their primary care doctor for an initial evaluation. So, it’s important to know how to screen for concussions and manage chronic and co-occurring symptoms.
DVBIC took current research, the latest clinical guidelines and expert contributions from Departments of Defense and Veterans Affairs to develop a suite of clinical recommendations, reference cards and training slides. All provide easy access to comprehensive guidance for assessment and prompt treatment. Here are four DVBIC resources for TBI-related conditions:
“Neuroimaging Following Mild TBI in the Non-Deployed Setting”: Provides a standard approach for imaging the acute through chronic stages following a concussion; describes clinical indications for neuroimaging in all stages; outlines red flags, history of mild TBI and special considerations for neuroimaging; specifies recommendations for acute, sub-acute, or chronic mild TBI
“Assessment and Management of Visual Dysfunction Associated with Mild TBI”: Provides a clinical recommendation, reference card and training slides that include key screening and eye and visual assessments; identifies red and yellow flags requiring urgent referral to appropriate specialists
“Assessment and Management of Dizziness Associated with Mild TBI”: Distinguishes categories of dizziness (vertigo, disequilibrium and lightheadedness); identifies effects of dizziness symptoms, medication side effects and polypharmacy issues; presents a clinical algorithm outlining steps to evaluate, manage or refer patients to specialty care
“Indications and Conditions for Neuroendocrine Dysfunction Screening Post Mild TBI”: Includes information on the co-occurrence of neuroendocrine dysfunction (NED) and mild TBI; identifies onset and manifestation of NED symptoms; provides an algorithm to inform providers of when to obtain labs and what labs are recommended if NED is suspected
You can order hard copies or download electronic versions of these clinical support tools and other resources at dvbic.dcoe.mil/resources.