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Recommendations for Grading of Concussion in Athletes

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Abstract

Mild sports-related concussions, in which there is no loss of consciousness, account for >[75% of all sports-related brain injury. Universal agreement on concussion definition and severity grading does not exist. Grading systems represent expertise of clinicians and researchers yet scientific evidence is lacking. Most used loss of consciousness and post-traumatic amnesia as markers for grading concussion. Although in severe head injury these parameters may have been proven important for prognosis, no study has done the same for sport-related concussion. Post-concussion symptoms are often the main features to help in the diagnosis of concussion in sport. Neuropsychological testing is meant to help physicians and health professionals to have objective indices of some of the neurocognitive symptoms. It is the challenge of physicians, therapists and coaches involved in the care of athletes to know the symptoms of concussion, recognise them when they occur and apply basic neuropsychological testing to help detect this injury. It is, therefore, recommended to be familiar with one grading system and use it consistently, even though it may not be scientifically validated. Then good clinical judgement and the ability to recognise post-concussion signs and symptoms will assure that an athlete never returns to play while symptomatic.

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Acknowledgements

The authors thank our McGill Sports Medicine Clinic colleagues for their support. We extend our sincere appreciation to Lynn Bookalam and Steve Cross for contributing their expertise and ideas to this manuscript.

Supported by the American College of Surgeons (KMJ).

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Authors and Affiliations

  1. McGill Sport Medicine Clinic, McGill University, 475 Pine Ave West, Montreal, QC, H2W 1S4, Canada

    Suzanne Leclerc, J. Scott Delaney, Vincent J. Lacroix & Karen M. Johnston

  2. Neuropsychology Department, University of Montreal, Montreal, Canada

    Maryse Lassonde

  3. McGill University Health Centre, Neurosurgery Department, McGill University, Montreal, Canada

    Karen M. Johnston

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  1. Suzanne Leclerc
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Leclerc, S., Lassonde, M., Scott Delaney, J. et al. Recommendations for Grading of Concussion in Athletes. Sports Med 31, 629–636 (2001). https://doi.org/10.2165/00007256-200131080-00007

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