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What are the real risks of sport-related concussion, and are they modifiable?

Published online by Cambridge University Press:  01 July 2009

CHRISTOPHER RANDOLPH  and
MICHAEL W. KIRKWOOD
CHRISTOPHER RANDOLPH*
Affiliation:
Department of Neurology, Loyola University Medical Center, Maywood, Illinois
MICHAEL W. KIRKWOOD
Affiliation:
Department of Physical Medicine & Rehabilitation, University of Colorado at Denver and The Children’s Hospital, Aurora, Colorado
*
*Correspondence and reprint requests to: Christopher Randolph, 1 East Erie, Suite 355, Chicago, Illinois 60611. E-mail: crandol@lumc.edu
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Abstract

Over the past two decades, the management of sport-related concussion has been the topic of increased attention in the scientific literature and in the popular media. Despite a proliferation of competing guidelines for concussion management, the widespread use of neuropsychological “baseline” testing designed to monitor postinjury recovery, and several prospective controlled studies of the natural history of concussion, there has been virtually no attempt to quantify the risks associated with sport-related concussion or to determine whether these risks are modifiable via management strategies. Using American football as a model, the short- and long-term risks of sport-related concussion are reviewed. It is concluded that serious short-term consequences of sport-related concussion are extremely rare and unlikely to be significantly modified via management strategies that rely on baseline testing. Other less serious short-term adverse outcomes are also quite rare, transient, and not likely to be altered by specific management guidelines. The long-term consequences of multiple sport-related head trauma remain unclear but are potentially of greater public health concern and should be the focus of increased research. Based on available evidence, there is little rationale for the use of rigid strategies or guidelines in the place of individual clinical decision-making in the management of these injuries. (JINS, 2009, 15, 512–520.)

Keywords

Brain injuryNeuropsychological testsGuidelinesBrain swellingPost-concussion syndromePsychometrics
Type
Critical Review
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 4 , July 2009 , pp. 512 - 520
Copyright
Copyright © The International Neuropsychological Society 2009

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