Current concepts in the treatment of sports concussions

The management of patients with sports-related concussion (SRC) is comprehensive and includes preseason planning, education, initial evaluation, postinjury assessment, disposition, return-to-play decisions, and consideration of long-term brain health. Several recent publications have addressed sports concussion management using the best available evidence, and we review them here. The diagnosis and management of sports concussion have evolved over the past several decades, and with a greater understanding of the importance of both short- and long-term sequelae, there has been a clear trend toward recognizing and treating these brain injuries more cautiously and developing a proactive approach to management and return-to-play decision making. Although each of these used different methodologies in their review of the literature, their conclusions are fairly consistent, providing basic guidelines for contemporary approaches to management of SRC. Although many questions remain unanswered, there are several areas of agreement including the importance of education, preseason assessment, the benefit and utility of a standardized multimodal assessment on the sidelines, individualized treatment and return-to-play protocols, and the benefit of a multidisciplinary team in managing complicated injuries. This paper reviews these current sports concussion guidelines and the best available evidence that guides current management of SRC.