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Concussion in sport has been defined as a “complex pathophysiological process affecting the brain, induced by biomechanical factors.”1 The condition is characterised by “a graded set of clinical symptoms that may or may not involve loss of consciousness.”1
Casting the net wide
The current consensus definition provides a broad clinicopathological description of concussion. It encompasses the wide range of clinical presentations that result from traumatic forces transmitted to the brain. In its most literal interpretation, any post-traumatic symptom or sign fits the definition of concussion.2 Consequently, the current definition has high sensitivity, but lacks specificity. This issue has been highlighted in recent papers.3
The purpose of ‘casting a large net’ is to capture all possible concussions and manage these injuries conservatively. This position is driven by the lack of reliable and specific diagnostic markers, and concerns related to potential complications associated with concussion. Compounding this, risk factors for complications remain unclear and currently there are few prognostic factors to accurately predict outcomes following concussion.4
Athletes do not like sitting out
From the athletes’ perspective, a significant downside to the broad definition of concussion is the major time …
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