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The sports concussion picture: fewer ‘pixels’, more HD
  1. Jon S Patricios1,2,
  2. Michael Makdissi3
  1. 1Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, Johannesburg, South Africa
  2. 2Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  3. 3The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Jon S Patricios, Section of Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, Johannesburg, P.O. Box 1267, Parklands 2121, South Africa; jpat{at}mweb.co.za

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“The only ones who see the whole picture, are the ones who step out of the frame” Salman Rushdie, The Ground Beneath Her Feet

Current concussion scrutiny

In contrast to the ‘whole picture’ described by Salman Rushdie, the media attention that concussion is currently receiving resembles a series of ‘pixels’. Not only journalists but coaches, athletes, parents and even medical colleagues often appear to focus on only one facet of the intricate picture that makes up the composite concussion portrait. Examples of ‘pixels’ include computerised cognitive tests, Rugby's pitch side suspected concussion assessment (PSCA) and chronic traumatic encephalopathy (CTE). Each of these topics is often scrutinised outside of the context of many other significant aspects of the concussion picture.

CTE is one of the SEM's ‘hot topics’ and the concussion strategies incorporated in collision sport are under increased scrutiny; in this edition of BJSM we provide updates on both.

The concussion status quo

Few other areas of clinical sports medicine have received as much systematic attention as concussion has in the last 12 years. Independent experts have summarised the published evidence following a review of the literature and critical discussion held in Zurich in November 2012. The medical community has embraced concussion understanding and the protocols defined by the 2013 Concussion in Sport Consensus Statement.1

The Concussion in Sport Consensus Statement is a document of significant gravitas because it captures the systematic NIH consensus format, which is inclusive of scientists and clinicians constituting more than just expert opinion. The protocol consists of

  • Predefining a group of key questions;

  • Identifying a body of relevant literature;

  • Two days of presentations by experts;

  • A third day of discussion and debate in closed session by an expert panel;

  • The drafting of …

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