Symptom-based assessment of the severity of a concussion

Abstract

This paper represents the first documentation of empirically derived indicators of the clinical course of postconcussion symptom resolution. Self-reported memory problems apparent 24 hours postconcussion were robust indicators of the severity of sports-related concussion and should be a primary consideration in determining an athlete's readiness to return to competition. A decline on neurocognitive testing was the only objective measure significantly related to the duration of symptoms. Neither a brief LOC nor a history of concussion was a useful predictor of the duration of postconcussion symptoms.

Tackling in Youth Football

“…29 Football players are among the team sport athletes at highest risk for catastrophic cervical spine injuries. 71 The annual incidence of catastrophic cervical spine injuries appears higher for collegiate players than for high school players (4.72 vs 1.10 per 100 000 participants). 77 68 Other authors have also cautioned that a lack of proper training may increase risk of injury.…”

“…17,18,71,72,79 A recent initiative by USA Football emphasizes keeping the head up during tackling to prevent catastrophic injuries as well as concussions, although this new coaching method needs further study.…”

“…Indeed, the 1976 banning of spear tackling has been widely credited with reducing the numbers of cervical spinal injuries resulting in quadriplegia. [70][71][72][73]77,87,88 Unfortunately, spear tackling has persisted even since the 1976 rule change, and cervical spine injuries continue to occur. 73,88,89 Modification and consistent enforcement of the rules may lead to a further decrease in the risk of injury, including catastrophic injuries.…”

Review of sports-related concussion: Potential for application in military settings

“…Retrograde amnesia occurs when the athlete does not remember events that occurred before the injury. Some authors consider postconcussion memory problems to be strongly associated with concussion severity, so memory deficits are often a major consideration in determining fitness to return to play after injury [26,31]. However, some studies consider the nature and duration of other postconcussion symptoms, such as headaches, dizziness, and blurred vision, to be more important predictors of injury severity than memory deficits alone [32][33].…”

“…The duration of LOC is a relatively good predictor of outcome in severe TBI but a less reliable predictor in MTBI [26][27]. Lovell et al studied 383 patients with MTBI and found that those with LOC did not necessarily have greater neuropsychological impairment [28].…”