Neuropsychology of sports-related head injury: Dementia Pugilistica to Post Concussion Syndrome

This article reviews the existing literature in the following areas of spor ts neuropsychology: Dementia Pugilistica, concussion and Post Concussion Sy ndrome, Second Impact Syndrome, and the emerging role of the sports neurops ychologist regarding return to play decisions. Dementia Pugilistica is disc ussed as a condition that exists along a continuum: Although many boxers wi ll develop mild neurocognitive deficits, it is not yet known what percent o f these mild presentations will progress to diagnosable Dementia Pugilistic a. Factors contributing to both increased and reduced risk are detailed. Th e role of neuropsychological assessment in research and clinical management is reviewed. Existing studies of concussion incurred during contact sports provide evidence of an important role for neuropsychology in assessment an d management of mild head injuries. Issues in clinical assessment of concus sion are reviewed. The importance of grading of concussions, monitoring of postconcussive symptom resolution, and the use of neuropsychological test r esults in return to play decisions is detailed. The Second Impact Syndrome is discussed with regard to return to play decisions. Recommendations are p roposed for research and for clinical application of findings in sports neu ropsychology.