The American Academy of Neurology has updated their guidelines for how to manage concussions.  Last updated in 1997, the new guidelines focus primarily on recovery after a concussion.  According to Ryan Jaslow, concussions should not be managed in a one-size-fits-all manner.  Rather each concussion needs to be evaluated and managed individually, with no set timelines for returning to play.

An estimated 3.8 million athletes sustain a sports-related traumatic brain injury each year in the United States, many of whom seek no immediate medical treatment. The new guidelines say athletes with a suspected concussion should be lifted from the game immediately and can’t return until a licensed health care professional trained in concussions allows them to return to play — slowly — after all symptoms are gone. The evidence reviewed by the guideline authors showed kids take longer to recover from a concussion than college athletes, so a more conservative approach is recommended when deciding if a child or teen athlete should return to play.


Other important findings noted in the studies that led to the new guidelines:


  • Football and rugby players have the highest risk of concussions, followed by hockey and soccer players.
  • There is less risk of concussions for those who play baseball, softball, volleyball, and gymnastics.
  • For female athletes, soccer and basketball pose the greatest risks for a concussion.
  • The first ten days after a concussion is when an athlete is most vulnerable to suffering a second concussion from another head-blow.   That could lead to “second-impact syndrome,” when the second concussion causes severe and life-threatening brain swelling.
  • The risk factors for chronic neuro-cognitive impairment include increased exposure to concussions as well as having the ApoE4 gene, which is associated with Alzheimer’s disease.
  • There is a lack of data showing that specific interventions or therapies improve short-term recovery time or decrease long-term post-concussion neuro-behavioral symptoms.


The bottom line for these guidelines, according to the authors, is to keep athletes of all ages off the field if there’s any chance they still have lingering symptoms from a head injury.


Quote to live by:

Said Kutcher, “You only get one brain; treat it well.”


**** If you or a coach or trainer suspects your child has suffered a concussion, call our offices.  Many of the doctors at Pediatric Alliance have been trained at the UPMC Sports Medicine Concussion Program to evaluate and manage children with concussions.  With an emphasis on thorough, serial histories and physical exams, along with the use of baseline and post-concussion computerized neuro-cognitive (“ImPACT”) tests, we can monitor your child’s progress as they improve and, ultimately, clear them to return to play when their symptoms have resolved and their ImPACT scores have returned to baseline.

Read article and see video from CBS News here.

Read new guidelines in Neurology here.

More on concussions on The PediaBlog here.