Implementation of Neuropsychological Testing Models for the High School, Collegiate, and Professional Sport Settings

OBJECTIVE: To review models for the use of neuropsychological testing in the management of sport-related concussion at various levels of competition. BACKGROUND: As we come to understand the natural history of sport-related concussive brain injury, it is increasingly evident that significant neurologic risks are associated with this type of injury. These risks include (1) acute intracranial pathology, (2) catastrophic brain swelling from second-impact syndrome, and (3) the potential risk for markedly prolonged recovery or permanent cognitive dysfunction associated with multiple concussions. DESCRIPTION: Neuropsychological testing has proved to be a useful tool in the medical management of sport-related concussion. In this paper, I describe a systematic model for the implementation of neuropsychological assessment of athletes at various levels of competition. CLINICAL ADVANTAGES: The systematic model was designed to incorporate state-of-the-art techniques for the detection and tracking of neurocognitive deficits associated with concussion into recently formulated guidelines for the medical management of sport-related concussion. Current applications of the model are discussed, as well as ongoing studies designed to elaborate the empirical underpinnings of the model and refine clinical decision making in this area.