Concussions by the Numbers

The SCAT3 is a standardized method of evaluating injured athletes for concussion ages 13 years and older. Although designed for use by medical and health professionals, it includes advice for athletes and parents about signs to watch for in the first 24 to 48 hours after suspected concussion and a list of other important points, including the need for rest and avoiding strenuous activity, and not training or playing sport until medically cleared.

Football is still responsible for the majority of concussions at the
high school level and the highest concussion rate.

In recent years, new scientific research and clinical-based literature have given the athletic training and medical professions a wealth of updated information on the treatment of sport-related concussion. To provide athletic trainers, physicians, other medical professionals, parents and coaches with recommendations based on these latest studies, the National Athletic Trainers' Association (NATA) has developed a set of guidelines to prevent and manage sport-related concussion and improve decisions about whether an athlete should or should not return to play after experiencing head trauma.

One of the signs usually but not always present with concussion is poor balance. An athlete's balance and equilibrium can be tested using low-technology, intermediate technology, and high-technology methods, but the most widely used and validated is the Balance Error Scoring System (BESS).

Second Impact Syndrome (SIS) occurs when an athlete who sustains a head injury - often a concussion or worse injury, such as a cerebral contusion (bruised brain) - sustains a second head injury before symptoms associated with the first have cleared. Typically, the athlete suffers post-concussion signs and symptoms after the first head injury, such as headache, visual, motor or sensory changes or mental difficulty, especially with the thought and memory process. Before these symptoms have cleared, which may take minutes, hours, days or weeks, the athlete returns to competition and receives a second blow to the head.

Because coaches have the strongest influence on a student-athlete's decision to report a concussion, more concussion education of coaches, including the need to report concussions, however, minor, and the creation of a safe reporting environment are critical, experts say, to combating chronic underreporting of concussion.

Because one of the keys to keeping athletes safe when it comes to concussion is education, a concussion education and safety meeting should be held for parents and athletes should be held before every season. Ideally, the meeting should include presentations by medical doctors, former athletes, and parents of concussed current or former athletes.

A multiple concussion history, especially where concussions occur with progressively less impact force, are considered modifying factors in the investigation and management of concussion under the current international consensus statement on concussions.

Team, physicians, athletic trainers, and other medical personnel responsible for the medical care of athletes face no more challenging problem than the recognition and management of concussion. Precisely how long a concussion disrupts the metabolic function of the brain is not presently fully understood, and there are no current neuroanatomic or physiologic measurements that can be used to precisely determine the extent of injury in concussion, the severity of metabolic dysfunction or precisely when it has cleared.