The American Academy of Neurology has released its guideline for evaluating and managing athletes with concussion. The AAN says that over one million sportsmen and sportswomen in the USA experience a concussion annually. This is the first concussion update in 15 years.



“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.”

  • Immediate action – any athlete with suspected concussion must be taken out of the game immediately

  • See a specialist – that athlete should not be allowed to return until an examination has been carried out by a licensed health care professional trained in concussion

  • A gradual return to play – return to play should be done slowly, and only after acute symptoms have completely disappeared

  • Children and teenagers – athletes up to high school age with a concussion “should be managed more conservatively” regarding when they be allowed to come back to the game. According to available evidence, this age group takes longer to recover than older sports people

The guideline says that:
  • The sports with the greatest risk of concussion are football and rugby, and then hockey and soccer, among males

  • Among females, soccer and basketball have the greatest risk of concussion

  • A sportsman or sportswoman who has already experienced at least one concussion is more likely to be diagnosed with another, compared to athletes with no history of concussion

  • After being diagnosed with concussion, the patient is at greatest risk of being diagnosed with another concussion during the following ten days

  • The authors found no compelling evidence that demonstrated that one type of football helmet is better than another at protecting the athlete against concussion.

  • Doctors who are trained in treating concussion should look for ongoing symptoms, particularly fogginess and headache, a history of concussions, and younger age in the athlete. These factors have been individually associated with longer recovery after a concussion.

  • Athletes with a prior concussion, long exposure to a sport, and those that have the ApoE4 gene have a higher risk of experiencing chronic neurobehavioral impairment.

  • Headache
  • Sensitivity to light
  • Sensitivity to sound
  • Changes to reaction time
  • Changes in judgment
  • Changes in speech
  • Changes in sleep
  • Loss of consciousness, or a ” blackout” (occurs in less than 10% of concussions)

“If in doubt, sit it out. Being seen by a trained professional is extremely important after a concussion. If headaches or other symptoms return with the start of exercise, stop the activity and consult a doctor. You only get one brain; treat it well.”

Should there be absolute rest after a concussion?

Sports Concussion Tool Kit – American Academy of Neurology

“Concussion Quick Check”

kids take longer to recover from second or third concussionsPedatrics