title: Changes in baseline concussion assessment scores following a school bus crash.
abstract: The objective of this article is to present concussion assessment data for 30 male athletes prior to and after being involved in a large school bus crash. The athletes on the bus, all male and aged 14-18 years, were participants in their school's concussion management program that included baseline and postinjury testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT).
  
  
  
  This case study described changes in concussion assessment scores for 30 male athletes following a primarily frontal school bus crash. Data from the school's concussion management program, including baseline test data and postinjury assessment data, were reviewed. Athletes who required multiple postinjury assessments by the program were identified as having had significant cognitive changes as a result of the bus crash.
  
  
  
  Twenty-nine of 30 athletes were injured. One had lumbar compression fractures; others had various lacerations, abrasions, contusions, sprains, and nasal fractures. ImPACT data (postcrash) were available for all 30 athletes and 28 had available precrash baseline data. A total of 16 athletes (53.3%) had significant cognitive changes indicated by changes in their concussion assessment scores, some of which took months to improve.
  
  
  
  This case study highlights a unique opportunity to evaluate concussion assessment data from 30 male athletes involved in a high-speed school bus crash. Further, these data provide additional insight into assessing the effectiveness of current school bus occupant protection systems.
authors: a National Transportation Safety Board, Office of Research and Engineering , Washington , D.C.
authors: Kristin M
authors: KM
authors: Poland
authors: a National Transportation Safety Board, Office of Research and Engineering , Washington , D.C.
authors: Mary Pat
authors: MP
authors: McKay
authors: b Hasbro Children's Hospital and Alpert Medical School of Brown University , Providence, Rhode Island.
authors: Mark R
authors: MR
authors: Zonfrillo
authors: c National Transportation Safety Board, Office of Highway Safety , Denver , Colorado.
authors: Thomas H
authors: TH
authors: Barth
authors: c National Transportation Safety Board, Office of Highway Safety , Denver , Colorado.
authors: Ronald
authors: R
authors: Kaminski
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D056352:Athletes / Q000523:psychology* / Q000706:statistics & numerical data; D001924:Brain Concussion / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003071:Cognition / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D018986:Motor Vehicles; D009483:Neuropsychological Tests; D012574:Schools
keywords: Concussion; athlete; cognitive testing; crash; school bus; transportation