What are the recommended guidelines for the follow-up and rehabilitation of patients after a mild traumatic brain injury?

Follow-up and rehabilitation after mild traumatic brain injury (mTBI) should include:

• Providing age-appropriate printed and verbal information to the patient and their families or carers about the nature and severity of the injury, the recovery process, potential delayed or persistent symptoms, and contact details for community and hospital services in case of complications or ongoing problems.
• Ensuring a responsible adult supervises the patient for the first 24 hours after injury to monitor for any neurological deterioration.
• Writing to the patient’s GP within 48 hours of discharge from the emergency department, detailing clinical history and examination findings, and sharing this information with relevant health professionals such as health visitors or school nurses.
• Referring patients with persisting symptoms or complications to clinicians trained in traumatic brain injury management, such as neurologists, neuropsychologists, clinical psychologists, neurosurgeons, endocrinologists, or multidisciplinary neurorehabilitation teams.
• Considering investigation and management of contributing factors to the injury, such as falls assessments or safeguarding referrals.
• Providing advice on alcohol or drug misuse if relevant at discharge.
• Ensuring patients are discharged only when their Glasgow Coma Scale (GCS) score is back to 15 or pre-injury baseline, and when appropriate supervision arrangements are in place at home or in care settings.

These steps aim to support safe recovery, early identification of complications, and appropriate rehabilitation pathways after mild traumatic brain injury.

References: NICE NG232