Concussion Management Guidelines Neglect Auditory Symptoms

Evidence-based guidelines are essential to promote and provide best practices. They present a logical framework for clinicians to find established criteria for diagnostic purposes and treatment recommendations. Unfortunately, many published guidelines for the assessment and management of patients with traumatic brain injury (TBI) or concussion fail to synthesize current knowledge pertaining to the occurrence of auditory symptoms at the time of injury or the recovery timeline for these symptoms.1–6 The underlying mechanisms for many auditory symptoms after head injury are poorly understood, which complicates classifying these symptoms as either “post- TBI related” or in the case of mild TBI (mTBI), “postconcussive related.” Identifying auditory symptoms that manifest secondary to head injury will aid in the assessment and treatment of these conditions. Most importantly, and the main issue addressed in this editorial, is that there are a number of auditory deficits besides vestibular injury that occur econdary to head injury, and, yet, often go unnoticed by health care professionals.