Review Question - QID 215551

Players with symptoms at rest should not be returned to contact activity under any circumstance.

Concussions are a subset of mild traumatic brain injuries that constitute 5-9% off all sports injuries. Assessment and management are centered around when a patient may safely return to play. Current treatment recommendations consist of cognitive and physical rest for 24-48 hours following by a gradual return-to-play protocol once the patient is asymptomatic. After the diagnosis of a concussion, same day return-to-play is contraindicated in all cases. Persistent symptoms following the diagnosis, including headache and blurred vision as seen in this patient, are an absolute contraindication to return to play.

Cahill et al review what orthopedic surgeons should know about concussions in an instructional course lecture. They report that current guidelines recommend a graded return to activity protocol after a patient is asymptomatic. They conclude that orthopedic surgeons should be aware of clinical features, clinical tools and consensus guidelines as it relates to concussion care.

Ma et al review the assessment and management of sports related concussions. They report that acute concussion symptoms are generally self-limited, and most symptoms resolve within 2 weeks from the inciting event. They conclude that while neuropsychologic testing can provide objective data on each athlete, this information cannot be used alone to decide when a patient may return to play.

Incorrect Answers:
Answers 1-3: Symptoms at rest, including a headache and blurred vision, are an absolute contraindication to return to activity.
Answer 5: Post-concussion symptoms may be present for up to 2 weeks. Advanced imaging is not indicated in this patient.