Current Concepts Review   |    
Sports-Related Concussion: Assessment and Management
Richard Ma, MD1; Chealon D. Miller, MD2; MaCalus V. Hogan, MD3; B. Kent Diduch, MD4; Eric W. Carson, MD3; Mark D. Miller, MD3
1 Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
2 Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Pittsburgh, PA 15213
3 Department of Orthopaedic Surgery, University of Virginia School of Medicine, P.O. Box 800159, Charlottesville, VA 22903. E-mail address for M.D. Miller: MDM3P@virginia.edu
4 Department of Health Sciences, James Madison University, MSC 4301, Harrisonburg, VA 22807
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Investigation performed at the University of Virginia, Charlottesville, Virginia

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Sep 05;94(17):1618-1627. doi: 10.2106/JBJS.K.01127
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Most major U.S. professional sports and the National Collegiate Athletic Association (NCAA) have adopted concussion policies. Current National Football League and NCAA guidelines do not permit an athlete with a concussion to return to play on the same day as the injury. No adolescent or high-school athletes with a concussion should be allowed to return to play on the same day regardless of severity.

Loss of consciousness is uncommon with concussion.

Acute concussion symptoms are generally self-limited, and most symptoms typically resolve within two weeks. Concussion risk and severity may be affected by age, sex, and genetic predisposition.

Athletes with a concussion should rest physically and cognitively until symptoms have resolved at rest and with exertion. Rehabilitation following concussion progresses through a stepwise graded fashion.

Neuropsychological testing can provide objective data on an athlete after a concussion. However, it alone cannot be used to diagnose a concussion or determine when an athlete is allowed to return to play.

Retirement from contact or collision sports may be necessary for an athlete who has sustained multiple concussions or has a history of prolonged symptoms after concussions.

Long-term effects of concussions are still relatively unknown, and further research is required to offer guidance for athletes of all levels.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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