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DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
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Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials
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Sports concussion management: part I.

Thomas R Terrell1, Timothy Nobles1, Brianna Rader1

  • 1From the University of Tennessee Graduate School of Medicine, Knoxville, the Department of Physical Education and Athletics, Catawba College, Salisbury, North Carolina, and the East Tennessee State University School of Medicine, Johnson City.

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Proper concussion management is crucial due to increased concerns about head injuries in sports. Updated clinical guidelines emphasize comprehensive evaluation and a phased return-to-play, moving away from outdated same-day protocols.

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Area of Science:

  • Sports Medicine
  • Neurology
  • Clinical Management

Background:

  • Concussion awareness has surged due to media coverage and concerns over repetitive head injuries in sports like football.
  • The clinical management of concussion is increasingly important for addressing potential short- and long-term implications.

Purpose of the Study:

  • To review updated clinical evaluation and management recommendations for concussion from international experts.
  • To guide clinicians in the proper diagnosis and treatment of concussion for optimal patient outcomes.

Main Methods:

  • Review of updated clinical evaluation and management recommendations.
  • Discussion of validated sideline assessment tools, such as the Sports Concussion Assessment Tool 2.
  • Exploration of computerized neuropsychological and balance testing for acute and ongoing evaluation.

Main Results:

  • Same-day return to play is considered outdated.
  • Current neuroimaging modalities have limitations in detecting structural damage from concussion.
  • New interventions like amantadine and cognitive rest may shorten recovery time.

Conclusions:

  • Appropriate concussion management typically leads to normal functional and neurocognitive outcomes.
  • Updated recommendations can enhance clinical decision-making for concussion care.
  • A phased approach to return-to-play is essential for athlete safety.