Citation

Berry JAD, Wacker M, Menoni R, Zampella B, Majeed G, Kashyap S, Ghanchi H, Elia C, Carson T, Miulli D. J. Am. Osteopath. Assoc. 2019; ePub(ePub): ePub.

Copyright

(Copyright © 2019, American Osteopathic Association)

DOI

10.7556/jaoa.2019.135

PMID

31764957

Abstract

The National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC) identified concussion and mild traumatic brain injury as not only a major public health concern but an epidemic.1 The annual incidence of concussion in the United States is estimated to be as high as 6 per 1000 people or 0.6% of the population.2 Concussion is one of the most commonly encountered conditions in sports medicine. While concussions are certainly not limited to sports, it is an area of intense national focus and debate. There are certain high-mechanism contact sports that have a higher risk of producing concussions, including high-speed collisions in baseball, falls from heights in gymnastics, checking in ice hockey, falling onto hardwood floors in basketball, and head-on collisions in soccer. Perhaps the most damaging sport of all is boxing, during which athletes take repeated blows to the head consistently in every encounter and are declared winners by “knockout,” when the opponent loses consciousness. The mechanism of concussion is not limited to the force of impact but is also influenced by an acceleration/deceleration injury.

Clinical Question: How is a concussion diagnosed and graded? What are the most current clinical guidelines published by authoritative medical societies based on expert consensus? When does the physician treating a young athlete who has just sustained a concussion allow the patient to return to play in competitive sports?

Evidence: The American Academy of Neurologists, the American Osteopathic Association, and other professional medical societies and commissions have all issued official statements about the danger of returning to play too early after an acute concussion or mild traumatic brain injury based on evidence that demonstrates concussions have additive effects, and patients are more vulnerable to secondary injury.

Recommendation: This review of the methods of diagnosing and grading concussion and mild traumatic brain injury and the official return to play guidelines will allow physicians to make the safest medical decisions ...

Language: en