OBJECTIVE: The objective of this article is to review the current literature relating to the chiropractic diagnosis and treatment of closed head trauma. It outlines the clinical exam, offers a diagnostic protocol and describes current chiropractic management and treatment of acute and chronic closed head trauma. Particular importance is placed on the need to differentiate between mild, moderate and severe head injury. Treatment protocols are elucidated for cerebral concussion and a rationale proposed for the management and treatment of posttraumatic concussion syndrome.

DATA SOURCES: Information was obtained from English language chiropractic, medical and scientific journals as well as chiropractic and medical textbooks. The CHIROLARS data retrieval system was used (year 0-1992) as was the MEDLINE data base (1988-1992). Head trauma, head injury, headache, concussion, vertigo, posttraumatic syndrome and whiplash injury were the indexing terms used.

CONCLUSION: The doctor of chiropractic is often the first practitioner a patient will see following a motor vehicle accident, sports injury or other acute trauma. The chiropractor is also the practitioner a patient seeks for help after suffering for months with chronic posttraumatic concussion syndrome. It is important that we have a protocol for effectively managing both acute and chronic closed head injury.

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