Medical and Non-Surgical Strategies for Mild Traumatic Brain Injury.

Historically, mild traumatic brain injury (mTBI) was often overlooked. However, growing clinical consensus emphasizes that active intervention is essential to manage physiological impairments and facilitate functional recovery. As secondary impact syndrome poses fatal risks during the acute phase, transitioning from passive rest to multimodal, active management is critical. This paper reviews current medical and non-surgical strategies for mTBI, shifting the paradigm from simple observation to proactive, evidence-based interventions. The review categorizes non-surgical interventions into 4 primary domains. First, lifestyle modification serves as the foundation, prioritizing 24-48 hours of rest, hydration, and minimized cognitive load from screens and light. Second, manual and physical therapies are employed; osteopathic manipulative medicine addresses musculoskeletal dysfunction, while hyperbaric oxygen therapy and blood flow restriction training support neurovascular repair and physical conditioning. Third, pharmacotherapy and supplementation focus on mitigating oxidative stress via antioxidants like MLC901 and enhancing cognitive function through medications such as methylphenidate or galantamine. Finally, active rehabilitation incorporates early intermediate-level aerobic exercise and vestibular rehabilitation to normalize cerebral blood flow and resolve balance deficits. The management of mTBI has evolved into a multimodal approach. By integrating these specialized strategies, clinicians can effectively mitigate long-term sequelae and promote rapid functional restitution.