Prospective longitudinal investigation shows correlation of event-related potential to mild traumatic brain injury in adolescents.

Study Design: Prospective longitudinal cohort study.

Background: Adolescent athletes may be more susceptible to the long-term effects of mild traumatic brain injury (mTBI). A diagnostic and prognostic neuromarker may optimize management and return-to-activity decision-making in athletes who experience mTBI.

Effect of Routine Sport Participation on Short-Term Clinical Neurological Outcomes: A Comparison of Non-Contact, Contact, and Collision Sport Athletes.

Objectives: To compare pre-season to post-season changes on a battery of clinical neurological outcome measures between non-contact, contact, and collision sport athletes over multiple seasons of play.

Methods: 244 high school and collegiate athletes participating in multiple non-contact, contact, and collision sports completed standardized annual pre-season and post-season assessments over 1-4 years. Pre/post-season changes in 10 outcome measures assessing concussion symptoms, neurocognitive performance, and balance were compared between the groups using linear mixed models.

Comparing the Acute Presentation of Sport-Related Concussion in the Pediatric and Adult Populations.

Despite growing research on concussion, there is minimal evidence comparing the acute presentation of concussion between pediatric and adult patients. This cross-sectional study compares injury characteristics, symptoms, and neurologic examination in sport-related concussion based on age. Patients presenting to an outpatient sports neurology clinic for initial assessment of concussion within 7 days of injury were divided into 2 groups, 18 and older (n = 28) and 17 and younger (n = 107).

The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale.

This paper presents the Sport Concussion Assessment Tool 5th Edition (SCAT5), which is the most recent revision of a sport concussion evaluation tool for use by healthcare professionals in the acute evaluation of suspected concussion. The revision of the SCAT3 (first published in 2013) culminated in the SCAT5. The revision was based on a systematic review and synthesis of current research, public input and expert panel review as part of the 5th International Consensus Conference on Concussion in Sport held in Berlin in 2016.

The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5): Background and rationale.

This article presents the Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5). The Sport Concussion Assessment Tool was introduced in 2004, following the 2nd International Conference on Concussion in Sport in Prague, Czech Republic. Following the 4th International Consensus Conference, held in Zurich, Switzerland, in 2012, the SCAT 3rd edition (Child SCAT3) was developed for children aged between 5 and12 years.

What are the critical elements of sideline screening that can be used to establish the diagnosis of concussion? A systematic review.

Background: Sideline detection is the first and most significant step in recognising a potential concussion and removing an athlete from harm. This systematic review aims to evaluate the critical elements aiding sideline recognition of potential concussions including screening tools, technologies and integrated assessment protocols.

Data Sources: Bibliographic databases, grey literature repositories and relevant websites were searched from 1 January 2000 to 30 September 2016.

Effect of Concussion on Performance of National Football League Players.

Purpose: Lingering neurologic injury after concussion may expose athletes to increased risk if return to play is premature. The authors explored whether on-field performance after concussion is a marker of lingering neurologic injury.

Design: Retrospective cohort study on 1882 skill-position players who played in the National Football League (NFL) during 2007-2010.

Summary of the 2015 University of Michigan Sport Concussion Summit.

Discussions surrounding concussion have made their way into the public sphere over the previous decade with media attention and coverage of the injury fueling public debate. These conversations have devolved into discussions on banning contact and collision sports and raised legal questions surrounding injury management. Questions raised about concussion eclipse what science can answer, but the University of Michigan Injury Center (MI, USA) hosted a Concussion Summit in September 2015 as a means to condense, solidify and disseminate what is currently known on the topic.

Is Migraine Headache Associated With Concussion in Athletes? A Case-Control Study.

Objective: The purpose of this study was to investigate the association between migraine headache and concussion in athletes.

Design: Case-control observational study.

Setting: A university-associated combined sports neurology and orthopedic sports medicine clinic.

A Clinical Approach to the Diagnosis of Traumatic Encephalopathy Syndrome: A Review.

Importance: Chronic traumatic encephalopathy (CTE) refers to pathologic changes that have been found in some individuals with a history of repetitive traumatic impact to the head (hereinafter referred to as head trauma). These changes cannot be assessed during the clinical evaluation of a living patient.

Observations: The neuropathologic features, taxonomy, history, role of biomarkers in diagnosis, and existing criteria of CTE are reviewed.

The Acute Management of Sport Concussion in Pediatric Athletes.

During the past two decades the focus on sport concussion has increased significantly. Young athletes represent the most vulnerable population to sustain a sport concussion yet receive the least amount of attention. Specifically, young athletes who sustain a sport concussion can go unrecognized and continue to participate in sport putting them at an increased risk for a more significant injury.

Developing guidelines for return to play: consensus and evidence-based approaches.

Background: Sports-related concussions are commonplace at all levels of play and across all age groups. The dynamic, evolving nature of this injury coupled with a lack of objective biomarkers creates a challenging management issue for the sports medicine team. Athletes who return to play following a concussion are known to be at higher risk for an additional brain injury, which necessitates a careful, informed return to play (RTP) process.

Analyzing the effect of state legislation on health care utilization for children with concussion.

Importance: In 2009, Washington State enacted legislation outlining the medical care of children and adolescents with concussion (ie, the Lystedt Law), with all other states and Washington, DC passing legislation by January 2014.

Objective: To evaluate the effect of concussion laws on health care utilization rates from January 1, 2006, through June 30, 2012, in states with and without legislation.

Design, Setting, And Participants: For commercially insured children aged 12 to 18 years from all 50 states and DC from January 1, 2006, through June 30, 2009, we examined the following: (1) prelegislation trends in concussion-related health care utilization from January 1, 2006, through June 30, 2009, (2) postlegislation trends in states without concussion legislation, and (3) the effect of state concussion laws on trends in states with concussion legislation in effect by means of negative binomial multivariable estimation with state and time fixed effects.

Sports concussion diagnosis and management.

Purpose Of Review: To provide the neurologist with a framework for the clinical approach to sports concussion diagnosis and management.

Recent Findings: As the issue of brain injury in athletes has emerged and developed, shifting the landscape of public concern, neurologists have become more directly involved in the diagnosis and management of sports concussion. Neurologists are now playing an increased role in acute concussion diagnosis, early injury management, return-to-play decisions, and evaluation for potential long-term effects from exposure to biomechanical forces on brain health.

An introduction to sports concussions.

Purpose Of Review: Concussions are a major public health issue, and particularly so in the setting of sports. Millions of athletes of all ages may face the risks of concussion and repeat concussion. This article introduces the terminology, epidemiology, and underlying pathophysiology associated with concussion, focused on sports-related injuries.

Current concepts in the treatment of sports concussions.

The management of patients with sports-related concussion (SRC) is comprehensive and includes preseason planning, education, initial evaluation, postinjury assessment, disposition, return-to-play decisions, and consideration of long-term brain health. Several recent publications have addressed sports concussion management using the best available evidence, and we review them here. The diagnosis and management of sports concussion have evolved over the past several decades, and with a greater understanding of the importance of both short- and long-term sequelae, there has been a clear trend toward recognizing and treating these brain injuries more cautiously and developing a proactive approach to management and return-to-play decision making.

National Athletic Trainers' Association position statement: management of sport concussion.

Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions.

Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity.

Effect of acute exercise on clinically measured reaction time in collegiate athletes.

Purpose: We have developed a reliable and valid clinical test of reaction time (RTclin) that is sensitive to the acute effects of concussion. If RTclin is to be used as a sideline concussion assessment tool then the acute effects of exercise on RTclin may need to be controlled for. The purpose of this study was therefore to determine the effect of exercise on RTclin.