Citation

Davis-Hayes C, Baker DR, Bottiglieri TS, Levine WN, Desai N, Gossett JD, Noble JM. Neurol. Clin. Pract. 2018; 8(1): 40-47.

Affiliation

College of Physicians & Surgeons (CD-H); Department of Pediatrics (DRB), Montefiore Medical Center; Department of Orthopedics (TSB, WNL, ND), Columbia University Medical Center; and Athletics Department (JDG), Department of Neurology, Taub Institute for Research on Alzheimer Disease and the Aging Brain (JMN), and G.H. Sergievsky Center (JMN), Columbia University, New York, NY.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1212/CPJ.0000000000000424

PMID

29517059

PMCID

PMC5839677

Abstract

PURPOSE OF REVIEW: In patients with a considerable history of sports-related concussion, the decision of when to discontinue participation in sports due to medical concerns including neurologic disorders has potentially life-altering consequences, especially for young athletes, and merits a comprehensive evaluation involving nuanced discussion. Few resources exist to aid the sports medicine provider. RECENT FINDINGS: In this narrative review, we describe 10 prototypical vignettes based upon the authors' collective experience in concussion management and propose an algorithm to help clinicians navigate retirement discussions. Issues for consideration include absolute and relative contraindications to return to sport, ranging from clinical or radiographic evidence of lasting neurologic injury to prolonged concussion recovery periods or reduced injury threshold to patient-centered factors including personal identity through sport, financial motivations, and navigating uncertainty in the context of long-term risks. SUMMARY: The authors propose a novel treatment algorithm based on real patient cases to guide medical retirement decisions after concussion in sport.

Language: en