An overview of concussion consensus statements since 2000

Cantu, Robert C.; Aubry, Mark; Dvořák, Jiří; Graf-Baumann, Toni; Johnston, Karen; Lovell, Mark R.; McCrory, Paul; Meeuwisse, W. H.; Schamasch, Patrick; Kevin, Murray; Bruce, S. L.; Ferrara, Michael S.; Kelly, James P.; McCrea, Michael; Putukian, Margot; McLeod, Tamara C. Valovich

doi:10.3171/foc.2006.21.4.4

Cited by 50 publications

(33 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This role is important because such guidelines recommend that athletes be asymptomatic before returning to full activity. 1,3,5,[36][37][38] Thus, baseline responses to measures of SRS require characterization and understanding before they are used as benchmarks for assessing the athlete and determining if he or she is asymptomatic. The most common symptoms reported during a nonconcussed baseline evaluation (fatigue, headache, difficulty concentrating, drowsiness, and trouble falling asleep) are also among the most commonly reported during a postconcussion evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, sports medicine clinicians have been encouraged to incorporate a multifaceted approach toward injury assessment and to use caution when interpreting responses to SRS scales. [1][2][3][4][5] The need for caution stems from the bias that may be present among athletes who are typically motivated to return to play and may feign the absence of SRS. 6 Additionally, postconcussion symptoms are by no means unique to concussive injuries.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Investigation of Baseline Self-Report Concussion Symptom Scores

Piland

Ferrara

Macciocchi

et al. 2010

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Self-reported symptoms (SRS) scales comprise one aspect of a multifaceted assessment of sport-related concussion. Obtaining SRS assessments before a concussion occurs assists in determining when the injury is resolved. However, athletes may present with concussion-related symptoms at baseline. Thus, it is important to evaluate such reports to determine if the variables that are common to many athletic environments are influencing them.Objective: To evaluate the influence of a history of concussion, sex, acute fatigue, physical illness, and orthopaedic injury on baseline responses to 2 summative symptom scales; to investigate the psychometric properties of all responses; and to assess the factorial validity of responses to both scales in the absence of influential variables.Design: Cross-sectional study. Setting: Athletic training facilities of 6 National Collegiate Athletic Association institutions.Patients or Other Participants: The sample of 1065 was predominately male (n 5 805) collegiate athletes with a mean age of 19.81 6 1.53 years.Main Outcome Measure(s): Participants completed baseline measures for duration and severity of concussion-related SRS and a brief health questionnaire.Results: At baseline, respondents reporting a previous concussion had higher composite scores on both scales (P # .01), but no sex differences were found for concussion-related symptoms. Acute fatigue, physical illness, and orthopaedic injury increased composite SRS scores on both duration and severity measures (P # .01). Responses to both scales were stable and internally consistent. Confirmatory factor analysis provided strong evidence for the factorial validity of the responses of participants reporting no fatigue, physical illness, or orthopaedic injury on each instrument.Conclusions: A history of concussion, acute fatigue, physical illness, and orthopaedic injury increased baseline SRS scores. These conditions need to be thoroughly investigated and controlled by clinicians before baseline SRS measures are collected.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Investigation of Baseline Self-Report Concussion Symptom Scores

Piland

Ferrara

Macciocchi

et al. 2010

Journal of Athletic Training

View full text Add to dashboard Cite

show abstract

“…During the past 20 years different organizations and research groups have developed guidelines and positional statements for the management of concussion in football and other sports (Aubry et al, 2002;Cantu et al, 2006;Casson, Pellman, & Viano, 2009a;Doolan, Day, Maerlender, Goforth, & Gunnar Brolinson, Field, Collins, Lovell, & Maroon, 2003;Giza et al, 2013;Guskiewicz et al, 2004;Harmon et al, 2013;Kirkwood, Yeates, & Wilson, 2006;Lovell & Fazio, 2008;McCrory et al, 2009;McCrory, Meeuwisse, Aubry et al, 2013). West & Marion (2014) have recently compared the current guidelines from the American Medical Society for Sports Medicine (Harmon et al, 2013), the American Academy of Neurology (Giza et al, 2013) .…”

Section: Introductionmentioning

confidence: 99%

Return to play management after concussion in football: recommendations for team physicians

Feddermann-Demont

Straumann

Dvořák

2014

Journal of Sports Sciences

View full text Add to dashboard Cite

A concussion is a rare but potentially serious injury of football players. Thus, an immediate and valid diagnosis, estimate of severity and therapeutic management is required. To summarise the published information on management of concussion with respect to a safe return to play (RTP), a literature search was conducted. Current guidelines on concussion in sports and significant studies on concussion in football were analysed. After concussion, management and RTP decision should remain in the area of clinical judgement on an individualised basis according to the current international guidelines. If a concussion is suspected, the player should not be allowed to RTP the same day. The RTP programme should follow a gradual step-wise procedure. A concussed player should not RTP unless he/she is asymptomatic and the neurological and neuropsychological examinations are normal. Untimely RTP bears an increased risk of sustaining another more severe brain injury and repetitive brain injury of long-term sequelae. In football, the management of concussion should primarily follow the recommendations proposed by the Concussion in Sports Group. Information and education of players and their medical and coaching team help to protect the players' health. Future studies on concussion should include validated and detailed information on RTP protocols. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58

show abstract

“…Relative NAA levels were calculated as the ratio of the peak area of NAA with that of Despite hundreds of studies and decades of research, there is currently no universally accepted definition of mild traumatic brain injury (mTBI) or concussion (3,12,15,17,18,46,53), even though it is often described as a traumatically induced alteration in mental status, not necessarily with loss of consciousness. As a direct consequence, diagnosis and management of mTBI represent a dilemma of inestimable proportion, considering that more than 75% of all TBIs are suspected to be mild and the majority of these are going unreported and unassessed by medical professionals.…”

Section: Mri and 1 H-mr Spectroscopy Acquisition Techniquesmentioning

confidence: 99%

Temporal Window of Metabolic Brain Vulnerability to Concussion

et al. 2008

View full text Add to dashboard Cite

OBJECTIVE:In the present study, the occurrence of the temporal window of brain vulnerability was evaluated in concussed athletes by measuring N-acetylaspartate (NAA) using proton magnetic resonance ( 1 H-MR) spectroscopy. METHODS: Thirteen nonprofessional athletes who had a sport-related concussive head injury were examined for NAA determination by means of 1 H-MR spectroscopy at 3, 15, and 30 days postinjury. All athletes but three suspended their physical activity. Those who continued their training had a second concussive event and underwent further examination at 45 days from the initial injury. The single case of one professional boxer, who was studied before the match and 4, 7, 15, and 30 days after a knockout, is also presented. Before each magnetic resonance examination, patients were asked for symptoms of mild traumatic brain injury, including physical, cognitive, emotional, and sleep disturbances. Data for 1 H-MR spectroscopy recorded in five normal, age-matched, control volunteers, who were previously screened to exclude previous head injuries, were used for comparison. Semiquantitative analysis of NAA relative to creatine (Cr)-and choline (Cho)-containing compounds was performed from proton spectra obtained with a 3-T magnetic resonance system. RESULTS: Regarding the values of the NAA-to-Cr ratio (2.21 Ϯ 0.11) recorded in control patients, singly concussed athletes, at 3 days after the concussion, showed a decrease of 18.5% (1.80 Ϯ 0.04; P Ͻ 0.001). Only a modest 3% recovery was observed at 15 days (1.88 Ϯ 0.1; P Ͻ 0.001); at 30 days postinjury, the NAA-to-Cr ratio was 2.15 Ϯ 0.1, revealing full metabolic recovery with values not significantly different from those of control patients. These patients declared complete resolution of symptoms at the time of the 3-day study. The three patients who had a second concussive injury before the 15-day study showed an identical decrease of the NAA-to-Cr ratio at 3 days (1.78 Ϯ 0.08); however, at 15 days after the second injury, a further diminution of the NAA-to-Cr ratio occurred (1.72 Ϯ 0.07; P Ͻ 0.05 with respect to singly concussed athletes). At 30 days, the NAAto-Cr ratio was 1.82 Ϯ 0.1, and at 45 days postinjury, the NAA-to-Cr ratio showed complete recovery (2.07 Ϯ 0.1; not significant with respect to control patients). This group of patients declared a complete resolution of symptoms at the time of the 30-day study. CONCLUSION: Results of this pilot study carried out in a cohort of singly and doubly concussed athletes, examined by 1 H-MR spectroscopy for their NAA cerebral content at different time points after concussive events, demonstrate that also in humans, concussion opens a temporal window of brain metabolic imbalance, the closure of which does not coincide with resolution of clinical symptoms. The recovery of brain metabolism is not linearly related to time. A second concussive event prolonged the time of NAA normalization by 15 days. Although needing confirmation in a larger group of patients, these results show that NAA measurement by 1 H-MR spe...

show abstract

An overview of concussion consensus statements since 2000

Cited by 50 publications

References 3 publications

Investigation of Baseline Self-Report Concussion Symptom Scores

Investigation of Baseline Self-Report Concussion Symptom Scores

Return to play management after concussion in football: recommendations for team physicians

Temporal Window of Metabolic Brain Vulnerability to Concussion

Contact Info

Product

Resources

About