Grade 1 or "ding" concussions in high school athletes.
BACKGROUND
Recent concussion management guidelines have suggested that athletes with mild (grade 1) concussions may be returned to play if asymptomatic for 15 minutes. The purpose of this study was to assess the utility of a current concussion management guideline in classifying and managing mild concussion.


OBJECTIVE
High school athletes diagnosed with a grade 1 concussion will demonstrate measurable decline in neuropsychological functioning that persists during the 1st week of recovery.


METHODS
Prospective study designed to evaluate neuropsychological functioning both prior to and following concussion.


METHODS
Forty-three high school athletes completed neuropsychological test performance and symptom ratings prior to the season and at two times during the 1st week following mild concussion.


RESULTS
Thirty-six hours after injury, mildly concussed high school athletes demonstrated a decline in memory (P < 0.003) and a dramatic increase in self-reported symptoms (P < 0.00001) compared to baseline performance.


CONCLUSIONS
Athletes with grade 1 concussion demonstrated memory deficits and symptoms that persisted beyond the context in which they were injured. These data suggest that current grade 1 return-to-play recommendations that allow for immediate return to play may be too liberal.


CONCLUSIONS
A reconsideration of current concussion grading systems appears to be warranted.
Lovell
Mark R
MR
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15203,USA.
Collins
Michael W
MW
Iverson
Grant L
GL
Johnston
Karen M
KM
Bradley
James P
JP
D000293:Adolescent; D000704:Analysis of Variance; D001265:Athletic Injuries / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D001924:Brain Concussion / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012647:Self-Assessment