The development of guidelines for the management of concussion in sports

Concussion in sports has caught the attention of the news media in recent years, primarily due to the high profile of certain athletes who have sustained traumatic brain injuries. Even though the management of concussion remains somewhat controversial, certain principles of neuroscience regarding mental status alterations and other symptoms resulting from concussion are well accepted by medical experts. Several authors have previously published management strategies for sports-related concussion based on their own experiences, but this article will describe the formal process of developing guidelines for the diagnosis and management of concussion in sports. The processes of literature review, evidence-based analysis, and consensus building are described. This article includes the grading scale, sideline evaluation, and management strategy adopted as a practice parameter by the American Academy of Neurology. Emphasis is placed on the need to detect mild forms of concussion through detailed observation and examination of athletes.