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OVERVIEW - INTRODUCTION

300,000 sports-related concussions in the United States per year; concussions are an unintended consequence of collision sports. Estimates vary regarding the likelihood of an athlete participating in a contact sport experiencing a concussion, but this may be as high as 10% per year in some sports. Furthermore, the effects of concussion are now known to be cumulative, even when the concussions are believed to be minor.

Concussions are complex; an athlete's presentation reflects unique combinations of cognitive, physical and subjective symptoms. Rest from physical activity and avoidance of high-risk activities are typically the most effective treatment strategy with most cases resolving relatively quickly (7 to 14 days).

Symptoms can resolve at different rates and to different degrees; it is important to objectively evaluate and monitor all symptoms, cognitive, physical and subjective, to best determine injury severity and to plan appropriately for the proper return to play (RTP) process. Although there are more than a dozen grading scales for severity and RTP guidelines the over-arching recommendation is that an athlete must be symptom free before they return to play.

Computerized neuropsychological testing is recommended to be part of the pre-participation evaluation - especially for those athletes who participate in organized high-risk sports, regardless of age or level of performance.

Concussion in Sport Group, (2005). Summary and agreement statement of the 2nd international symposium on concussion in sport, Prague 2004. Clinical Journal of Sport Medicine, 15, 48-55.

Neuropsychological measures: shown to be sensitive to the effects of concussion and proven to be effective in objectively evaluating brain function. It is most useful when pre-injury "baseline" data is available for each athlete that can serve as a unique comparison point for that particular individual in the event of an injury. Neuropsychology offers unique and critical information that, when combined with data from the athlete, parent, athletic trainer and medical doctor, provides for the most effective and comprehensive system to manage sport-related concussions.

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