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National Football League Head, Neck and Spine Committee’s Concussion Diagnosis and Management Protocol: 2017-18 season
  1. Richard G Ellenbogen1,
  2. Hunt Batjer2,
  3. Javier Cardenas3,
  4. Mitchel Berger4,
  5. Julian Bailes5,6,
  6. Elizabeth Pieroth5,
  7. Robert Heyer7,
  8. Nicholas Theodore8,
  9. Wellington Hsu9,
  10. Elizabeth Nabel10,
  11. Joe Maroon11,
  12. Robert Cantu12,
  13. Ronnie Barnes13,
  14. James Collins14,
  15. Margot Putukian15,
  16. Russell Lonser16,
  17. Gary Solomon17,
  18. Allen Sills18
  1. 1University of Washington School of Medicine, Seattle, Washington, USA
  2. 2University of Texas Southwestern School of Medicine, Dallas, Texas, USA
  3. 3Barrow Neurological Institute, Phoenix, Arizona, USA
  4. 4San Francisco School of Medicine, University of California, San Francisco, California, USA
  5. 5NorthShore University Health System, Chicago, Illinois, USA
  6. 6University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
  7. 7Carolinas Medical Center, Charlotte, North Carolina, USA
  8. 8Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  9. 9Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
  10. 10Brigham and Women’s Hospital, Boston, Massachusetts, USA
  11. 11University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  12. 12Boston University School of Medicine, Boston, Massachusetts, USA
  13. 13New York Giants Football Club, New York City, New York, USA
  14. 14Los Angeles Chargers Football Club, Los Angeles, California, USA
  15. 15Princeton University Health Services, Princeton, New Jersey, USA
  16. 16The Ohio State University School of Medicine, Columbus, Ohio, USA
  17. 17Vanderbilt University School of Medicine, Nashville, Tennessee, USA
  18. 18Department of Health and Safety, National Football League, New York City, New York, USA
  1. Correspondence to Dr Gary Solomon; gary.solomon{at}


One of the National Football League’s (NFL) Head, Neck and Spine Committee’s principal goals is to create a ‘best practice’ protocol for concussion diagnosis and management for its players. The science related to concussion diagnosis and management continues to evolve, thus the protocol has evolved contemporaneously. The Fifth International Conference on Concussion in Sport was held in Berlin in 2016, and guidelines for sports concussion diagnosis and management were revised and refined. The NFL Head, Neck and Spine Committee has synthesised the most recent empirical evidence for sports concussion diagnosis and management including the Berlin consensus statement and tailored it to the game played in the NFL. One of the goals of the Committee is to provide a standardised, reliable, efficient and evidence-based protocol for concussion diagnosis and management that can be applied in this professional sport during practice and game day. In this article, the end-of-season version of the 2017–18 NFL Concussion Diagnosis and Management Protocol is described along with its clinical rationale. Immediate actions for concussion programme enhancement and research are reviewed. It is the Committee’s expectation that the protocol will undergo refinement and revision over time as the science and clinical practice related to concussion in sports crystallise

  • national football league
  • concussion
  • protocol
  • mild traumatic brain injury
  • american football

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  • Contributors RGE, HB and AS were the primary authors of the manuscript. All authors contributed to the manuscript and approved the final version. GS co-ordinated the preparation of the manuscript for publication.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests All authors have received expense reimbursements from the National Football League (NFL) for participation in their activities related to the Head, Neck and Spine Committee. AS is an employee of the NFL. RB and JC are employed by NFL teams. RC, EN and GS have received consulting fees from the NFL.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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