Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD
The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2.
Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite symptoms from etiologies other than concussion.3
Animal models have demonstrated loss of ionic gradients in the CNS following concussion and reduced cerebral blood flow.5 Increased activity of Na/K ATPase leads to a relative insufficiency in ATP
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