HOW IS A CONCUSSION DIAGNOSED?
When concussion is suspected, a trained coach, certified athletic trainer, or the team physician should immediately perform an initial "sideline" evaluation, including:
Symptoms list review
Focused neurological exam
Focused orientation exam that tests short-term memory recall such as the event, play, opponent, score or last meal
Focused orientation exam that tests long term recall such as name, birth date, place of birth
Assessment of athlete's ability to stay attentive to a complex task such as reciting months backwards
If left undiagnosed, a concussion may place an athlete at risk of developing second impact syndrome-a potentially fatal injury that occurs when an athlete sustains a second head injury before a previous head injury has completely healed.
WHAT ARE THE SIGNS/SYMPTOMS OF A CONCUSSION?
Concussion symptoms include the following:
Difficulty communicating, concentrating
Feeling mentally foggy
Numbness or tingling
Sensitivity to light or noise
Sleeping more than usual or difficulty falling asleep
Visual problems - blurry or double vision
WHEN IS IT SAFE TO RETURN TO PLAY?
All athletes who sustain a concussion-no matter how minor-should undergo an evaluation by a qualified healthcare provider before returning to play. Athletes can return to play after they are completely free of all symptoms of a concussion and remain symptom free during and after physical testing.
Unfortunately, it is difficult to determine if the brain has healed from a concussion; even after all symptoms have resolved, healing may not be complete. Neurocognitive testing can be a very helpful tool in determining brain function. With a comparison to a baseline test, this evaluation can be used in conjunction with a physician's examination to reduce future risks.
Baseline testing collects data on an athlete's cognitive and physical abilities prior to suffering the concussion. Baseline testing can include a neurocognitive evaluation (usually by computer) that tests multiple areas of brain function, including memory, problem solving, reaction times, and brain processing speeds. Symptom checklists, sideline assessment tools such as the Sideline Concussion Assessment Tool (SCAT), and balance testing are other examples of baseline evaluations that may be helpful.
REFERENCES AND ADDITIONAL RESOURCES
Centers for Disease Control (CDC), Concussion Management Guidelines, Physician Tool Kit. 2007.
International Conference on Concussion in Sport, Vienna, 2001; Prague, 2004; Zurich, 2008
The following expert consultants contributed to the tip sheet:
Jeffrey S. Kutcher, MD
Wayne Sebastianelli, MD
Sports Tips provide general information only and are not a substitute for your own good judgement or consultation with a physician.