Review Question - QID 217930

Resuming sports activities after a sports-related concussion is determined by a graduated return-to-play protocol where the athlete must remain asymptomatic prior to progressing.

Concussions are mild traumatic brain injuries that are common in contact and combat sports. These injuries are taken seriously as a second injury occurring within a short time of the original can lead to second impact syndrome, which can be fatal due to loss of cerebral autoregulation. To prevent this complication, athletes that sustain a concussion must remain out of sports until they complete a graduated return-to-play protocol.

McCrory et al. formed a consensus statement on the management of sports-related concussions. They recommended players with suspected concussions should be evaluated by physicians and screened using the SCAT5 assessment tool and no return if there are concerning signs or symptoms. They stated athletes should begin a graduated return-to-play protocol after they have become symptom-free.

Shirley et al. reviewed the management of sports-related concussions. They stated concussion risk factors are age <18 years, female sex, history of previous concussion, and the initial treatment consists of reduced cognitive activity and physical rest. They concluded the long-term consequences of concussions are not fully understood.

Herring et al. provided a consensus statement for the management of sports-related concussions for the team physician. They emphasized the importance of cognitive rest, no same-day return-to-play, neurological examinations, and cognitive testing.

Incorrect answers
Answer 1: Athletes that sustain concussions cannot return-to-play the same day of the injury.
Answers 2 and 5: Prior to returning to sport the athlete must complete a graduated protocol and remain symptom-free during each of the phases.
Answer 4: Completing a neuropsychiatric evaluation is not necessary to return-to-play, but it is helpful for establishing a baseline after the injury.