title: Sports concussion management: part I.
abstract: Concussion is a popular clinical topic that has been the subject of unprecedented recent media coverage. As concerns about the potential short- and long-term implications of repetitive head injury in sports such as football continue to mount, the proper clinical management of concussion seems to increase in importance. The days of ignoring the "ding" on the sideline are definitely over. A series of updated clinical evaluation and management recommendations from international experts are highlighted in this review. The clinical presentation of an acute concussion, both the typical and more subtle variations, may be evaluated with new validated sideline evaluation tools (eg, Sports Concussion Assessment Tool 2). In addition, the role of computerized neuropsychological and balance testing in the acute and ongoing evaluation are discussed, along with how they contribute to the return-to-play decision. Same-day return to play is outdated, and the relative insensitivity of current neuroimaging modalities to demonstrate structural damage is highlighted. New therapeutic interventions such as amantadine and cognitive rest may improve recovery time. The appropriate management of concussion typically results in a normal functional and neurocognitive outcome. The recommendations in this article may guide clinicians, with varying degrees of prior experience managing concussion, to increase the likelihood of an excellent outcome.
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Terrell
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Timothy
authors.initials: T
authors.lastname: Nobles
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Brianna
authors.initials: B
authors.lastname: Rader
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bielak
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Irfan
authors.initials: I
authors.lastname: Asif
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Robert
authors.initials: R
authors.lastname: Casmus
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Jamie
authors.initials: J
authors.lastname: Yeager
authors.affiliation: From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.
authors.forename: Reem
authors.initials: R
authors.lastname: Hussein
mesh_terms: D001265:Athletic Injuries / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001924:Brain Concussion / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D020127:Recovery of Function