What should a healthcare practitioner’s initial exam include when examining a patient with a suspect concussion?

According to the BC Injury Research and Prevention Unit, the key features of the initial exam should include:

  • A medical assessment encompassing
  • A comprehensive history
  • Mechanism of injury
  • Time and date of injury
  • A detailed neurological examination that includes a thorough assessment of
    • Mental status
    • Cognitive function
    • Gait balance
  • A determination of the clinical status of the patient including whether there has been improvement or deterioration since the time of injury
    • Assessment of signs and symptoms may be done with the help of the Post-concussion Symptoms Checklist given to patient/family member to complete in the waiting room before the medical assessment.
    • This may involve seeking additional information from parents, coaches, teammates and/or eyewitnesses to the injury.
  • A determination of the need for emergent neuroimaging in order to exclude a more severe brain injury involving a structural abnormality (BCIRPU, 2015)

When should a patient be referred to a specialist for further treatment?

  • Any indication or suspicion of neurologic deterioration
  • Patients whose symptoms remain steady or worsen after 3 to 5 days
  • If you need help to manage the return to cognitive/physical exertion protocol
  • Young children exhibiting the following symptoms for an extended period of time​​
    • Excessive crying
    • Poor attention
    • Change in sleep patterns
    • Sad or lethargic mood, increased temper, becomes upset easily


​​​​​​What is a concussion?

A concussion is a disturbance in brain function cause by a direct or indirect force to the head. It results in a variety of non-specific signs and/or symptoms (some examples listed below) and most often does not involve loss of consciousness. 

How can treatment benefit you? 

Our therapists have training in mild traumatic brain injury and associated spinal dysfunction.  There specialty is concussion assessment and management of concussion related symptoms caused by the injury.  

On your initial visit there will be a thorough assessment of your symptoms using the ACE (Acute Concussion Evaluation) form as well as visual and vestibular checks. We also utilize up to date return to work/school and sport protocol to make sure that you are ready for all types of activities. 

Our concussion assessment is also accompanied by a cervical assessment and treatment including but not limited to: fascial work and myofascial trigger points, to the anterior, lateral and posterior side of the neck as well as jaw treatment. 

Common concussion symptoms and problems

For the latest information and poster regarding concussion please visit the link below to get

your own pdf version.  

Perfect for the office or home!

What is the most important change to the diagnosis of a concussion?

There is no scientific evidence to support a grading system for the diagnosis or management of a concussion. Research has suggested that a brief loss of consciousness (LOS) is not necessarily as significant an indicator of concussion severity as one thought (BCIRPU, 2015).

Patients are diagnosed as having a concussion if there is the presence of one or more signs and/or symptoms which can be categorized as physical, emotional, cognitive and/or associated with sleep disturbances.