Opinion about post-concussion syndrome in health professionals

Objective: To compare opinion about post-concussion syndrome (PCS) in accident and emergency doctors, clinical neuropsychologists and neurosurgeons. Method: A UK postal survey was sent to all accident and emergency doctors, neurosurgeons and clinical neuropsychologists listed by their professional bodies. Predictions of symptom complaint were made from a vignette about minor traumatic brain injury and a questionnaire about PCS-symptoms, cause, recovery and treatment. Results: All professional groups named headache, attention and memory difficulties as most common symptoms. Clinical neuropsychologists listed more symptoms at recall, more often achieved 'caseness' (Diagnostic and Statistical Manual-IV or International Classification of Diseases-10 criteria) and were more optimistic about treatment effectiveness. Neurosurgeons were more pessimistic about recovery. Organic factors were most frequently cited as the main cause of PCS, followed by emotional factors and then compensation factors. Conclusions: There was fair consistency between professional groups regarding PCS. Differences may reflect differing clinical roles between the professions, in terms of early care and late rehabilitation. The usefulness of the concept of PCS is discussed. All groups and particularly those working in acute settings may benefit from further information about minor brain injury including the effectiveness of psychological interventions.