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Pharmacological Therapies for Concussions

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Tackling the Concussion Epidemic

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Abstract

The pharmacological approach to concussion can be framed as targeting secondary injury mechanisms and/or targeting symptoms associated with concussion and persistent concussion syndrome (PCS). As we understand concussion and PCS better, and the role of comorbidities that are either pre-existent or precipitated, the approach also includes the active identification of clinical entities that are amenable to evidence-based interventions. Of course, the goal is to achieve a clinical pathological correlation, as well as an understanding of the pathophysiology and its precision mitigation in concussion. Unfortunately, there is generally a lack of evidence-based direction to guide treatments. Furthermore, while there is evidence following concussions/mild traumatic brain injury (mTBI) of persisting cellular changes from laboratory-supported research, this is largely in the context of the absence of evident anatomical injury or lesions by basic clinical imaging adding to the challenges of clinical research. This chapter, therefore, provides a description of recent history of the development of a pharmacologic approach to the secondary cellular mechanisms, largely in the context of moderate or severe TBI. This narrative arises from the assumption that the traumatic etiology in concussion points to a shared pathophysiology and pharmacologic potential. The chapter ends with a brief survey of the pharmacological approaches for treating symptoms of neurotransmitter dysfunction and concussion-related co-morbidities, while recognizing the importance of a multi-dimensional approach, as discussed in many chapters of this book.

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Authors and Affiliations

  1. Spinal Cord & Brain Injury Research Center (SCoBIRC), University of Kentucky College of Medicine, Lexington, KY, USA

    Edward D. Hall

  2. Keenan Research Centre, Li Ka Shing Knowledge Institute at St. Michael’s Hospital, Toronto, ON, Canada

    Eugene Park

  3. Departments of Critical Care and Anesthesia, St. Michael’s Hospital, Unity Health Toronto and University of Toronto, Toronto, ON, Canada

    Andrew J. Baker

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  1. Edward D. Hall
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  2. Eugene Park
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  3. Andrew J. Baker
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Correspondence to Edward D. Hall .

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Editors and Affiliations

  1. Keenan Research Centre, St. Michael’s Hospital, Unity Health Toronto and University of Toronto (Neurosurgery), Toronto, ON, Canada

    Tom A. Schweizer

  2. Departments of Critical Care and Anesthesia, St. Michael’s Hospital, Unity Health Toronto and University of Toronto, Toronto, ON, Canada

    Andrew J. Baker

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Hall, E.D., Park, E., Baker, A.J. (2022). Pharmacological Therapies for Concussions. In: Schweizer, T.A., Baker, A.J. (eds) Tackling the Concussion Epidemic. Springer, Cham. https://doi.org/10.1007/978-3-030-93813-0_9

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