Return to work
Determining the ideal time for a person to return to work will depend on personal factors and job-related factors including the intensity of the job and the risk of falling or hitting ones head at work during recovery. After the required initial recovery period of complete rest (24–48 hours after the concussion began), gradually and safely returning to the workplace with accommodations and support in place, should be prioritized over staying home and resting for long periods of time, to promote physical recovery and reduce the risk of people becoming socially isolated. The person should work with their employer to design a step-wise "return-to-work" plan. For those with a high-risk job, medical clearance may be required before resuming an activity that could lead to another head injury. Students should have completed the full return-to-school progression with no academic accommodations related to the concussion required before starting to return to part-time work. Prognosis
The majority of children and adults fully recover from a concussion, however some may experience a prolonged recovery. There is no single physical test, blood test (or fluid biomarkers), or imaging test that can be used to determine when a person has fully recovered from concussion.A persons recovery may be influenced by a variety of factors that include age at the time of injury, intellectual abilities, family environment, social support system, occupational status, coping strategies, and financial circumstances. Factors such as a previous head injury or a coexisting medical condition have been found to predict longer-lasting post-concussion symptoms.
It was agreed that concussion typically involves temporary impairment of neurological function that heals by itself within time, and that neuroimaging normally shows no gross structural changes to the brain as the result of the condition.However, although no structural brain damage occurs according to the classic definition, some researchers have included injuries in which structural damage has occurred and the National Institute for Health and Clinical Excellence definition includes physiological or physical disruption in the brains synapses. Also, by definition, concussion has historically involved a loss of consciousness. However, the definition has evolved over time to include a change in consciousness, such as amnesia, although controversy continues about whether the definition should include only those injuries in which loss of consciousness occurs. This debate resurfaces in some of the best-known concussion grading scales, in which those episodes involving loss of consciousness are graded as being more severe than those without.Definitions of mild traumatic brain injury (mTBI) were inconsistent until the World Health Organizations International Statistical Classification of Diseases and Related Health Problems (ICD-10) provided a consistent, authoritative definition across specialties in 1992. Since then, various organizations such as the American Congress of Rehabilitation Medicine and the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders have defined mTBI using some combination of loss of consciousness (LOC), post-traumatic amnesia (PTA), and the Glasgow Coma Scale (GCS). Concussion falls under the classification of mild TBI, but it is not clear whether concussion is implied in mild brain injury or mild head injury.