Sports-Related Concussions & Subconcussive Injuries

A multiple concussion history, especially where concussions occur with progressively less impact force, are considered modifying factors in the investigation and management of concussion under the current international consensus statement on concussions.

Study shows LOC of greater than one minute duration may be associated with delayed return to play.  As a result, prolonged LOC is considered a factor that may influence management of such concussions.

Team, physicians, athletic trainers, and other medical personnel responsible for the medical care of athletes face no more challenging problem than the recognition and management of concussion. Precisely how long a concussion disrupts the metabolic function of the brain is not presently fully understood, and there are no current neuroanatomic or physiologic measurements that can be used to precisely determine the extent of injury in concussion, the severity of metabolic dysfunction or precisely when it has cleared.

The current international consensus of concussion experts recognizes that they lack the ability to predict injury severity or
outcomes at the time of concussion injury, calls for consideration of range of "modifying factors."

A study of elite athletes playing contact sports suggests that the symptoms of depression some experience after a concussion may result from physical changes in their brains caused by the concussions themselves.

Regardless of which return to play guidelines a child's school or sports program follows for concussions, they are just guidelines, not ironclad rules, with a child's return to play determined on case-by-case basis.

Until 2004, the three most commonly used concussion grading systems were the Cantu, Colorado Medical Society (CMS), and American Academy of Neurology (AAN) guidelines. They have since been abandoned in favor of a symptom-based approach to individually guide management and return to play decisions.