title: Epidemiology, trends, assessment and management of sport-related concussion in United States high schools.
abstract: OBJECTIVE
  Sport-related concussion affects athletes at every level of participation. The short and long-term effects of concussions that occur during childhood and adolescence are not fully understood. The purpose of this review is to describe the current burden of disease, current practice patterns and current recommendations for the assessment and management of sport-related concussions sustained by United States high school athletes.
  
  
  RESULTS
  Millions of high school students participate in organized sports in the United States. Current estimates suggest that, across all sports, approximately 2.5 concussions occur for every 10 000 athletic exposures, in which an athletic exposure is defined as one athlete participating in one game or practice. At schools that employ at least one athletic trainer, most high school athletes who sustain sport-related concussions will be cared for by athletic trainers and primary care physicians. Approximately 40% will undergo computerized neurocognitive assessment.
  
  
  CONCLUSIONS
  The number of high school athletes being diagnosed with sport-related concussions is rising. American football has the highest number of concussions in high school with girls' soccer having the second highest total number. Fortunately, coaches are becoming increasingly aware of these injuries and return-to-play guidelines are being implemented.
authors.affiliation: Brain Injury Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Réjean M
authors.initials: RM
authors.lastname: Guerriero
authors.forename: Mark R
authors.initials: MR
authors.lastname: Proctor
authors.forename: Rebekah
authors.initials: R
authors.lastname: Mannix
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D001924:Brain Concussion / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D013334:Students; D014481:United States / Q000453:epidemiology