Summary of evidence-based guideline update: Evaluation and management of concussion in sports

Abstract

Objective: To update the 1997 American Academy of Neurology (AAN) practice parameter regarding

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

“…In children, factors potentially influen cing recovery include age and history of concussions. 27,28 In one study, approximately 90% of young adult male athletes experienced symptomatic recovery within 21 days. 29 However, in an emergency department study of patients aged 11-22 years (including all causes of concussion, not just sports-related), 15% of the sample still exhibited post-concussion symptoms, including headache, dizziness, 'mental fogginess' and depression, 90 days after injury.…”

“…42 Young athletes of both sexes are at risk of concussion, but girls report higher concussion rates than boys, particularly in high school and college soccer, basketball, and baseball or softball. 28,[43][44][45] The factors that account for these differences remain uncertain, but might include quality of protective gear, recognition and reporting of concussion symptoms, and neck length and neck muscle strength. 46 Differences in recovery trajectories between males and females are also poorly understood.…”

“…No causal link between CNI and head trauma has yet been confirmed, but a dose-dependent risk has consistently been found in professional athletes. 28 In addition, almost half of the studies conducted in amateur athletes have found an elevated risk of CNI. 28 Whether similar risk associations are present in younger populations remains to be determined.…”

Addressing Concussion in Youth Sports

“…This includes better concussion education for students entering health professions but also improved education for health care professionals after graduation [10,11]. A study found that only 26.6 percent of general pediatricians were somewhat or very familiar with recently passed concussion legislation and that only 14.6 percent of general pediatricians used concussion consensus guidelines in their practice [12]. An informed primary care clinician can provide crucial anticipatory guidance for safe sport participation, like reminders to wear helmets and use the proper protective equipment.…”

One-Year Concussion Prevalence in Marion County, Florida High School Athletes

“…9,2 This attention has led to updated guidelines for reporting and management of concussion or mild traumatic brain injury in athletic competition. 10 These new expectations open the door to challenge the findings of prior prevalence studies from an era where reporting was often minimized to reduce time out of competition. 2 In Marion County, Florida, the athletic director has established guidelines requiring all trainers to document each concussion reported during practice or competition.…”