Sunday, August 04, 2013

Updates to concussion guidelines

The American Academy of Neurology recently updated the 1997 concussion guidelines in effort to make football and other contact sports safer.

UPI reported on evidence-based guidelines for managing concussions that were published Monday in the journal Neurology that it said affect more than 1 million Americans each year.
Co-lead guidelines author Dr. Christopher C. Giza of the David Geffen School of Medicine and Mattel Children's Hospital at University of California, Los Angeles, said the new guidelines replaced the 1997 American Academy of Neurology guidelines on concussions.

"Among the most important recommendations the academy is making is that any athlete suspected of experiencing a concussion immediately be removed from play," Giza said in a statement.

"We've moved away from the concussion grading systems we first established in 1997 and are now recommending concussion and return to play be assessed in each athlete individually. There is no set timeline for safe return to play."

Athletes of high school age and younger with a concussion should be managed more conservatively in regard to return to play, because they take longer to recover than college athletes.

PRNewswire published the full guidelines.
According to the guidelines:

* Among the sports in the studies evaluated, risk of concussion is greatest in football and rugby, followed by hockey and soccer. The risk of concussion for young women and girls is greatest in soccer and basketball.

* An athlete who has a history of one or more concussions is at greater risk for being diagnosed with another concussion.

* The first 10 days after a concussion appears to be the period of greatest risk for being diagnosed with another concussion.

* There is no clear evidence that one type of football helmet can better protect against concussion over another kind of helmet. Helmets should fit properly and be well maintained.

* Licensed health professionals trained in treating concussion should look for ongoing symptoms (especially headache and fogginess), history of concussions and younger age in the athlete. Each of these factors has been linked to a longer recovery after a concussion.

* Risk factors linked to chronic neurobehavioral impairment in professional athletes include prior concussion, longer exposure to the sport and having the ApoE4 gene.

* Concussion is a clinical diagnosis. Symptom checklists, the Standardized Assessment of Concussion (SAC), neuropsychological testing (paper-and-pencil and computerized) and the Balance Error Scoring System may be helpful tools in diagnosing and managing concussions but should not be used alone for making a diagnosis.

Signs and symptoms of a concussion include:

* Headache and sensitivity to light and sound
* Changes to reaction time, balance and coordination
* Changes in memory, judgment, speech and sleep
* Loss of consciousness or a "blackout" (happens in less than 10 percent of cases).

Read more here

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