Injury severity and neuropsychological and balance outcomes of four college athletes

Recent evidence suggests significant short-term neurocognitive deficits fol lowing mild traumatic brain injury (MTBI) in sports. However, sequelae of m ild head injuries is complicated by many factors including a history of mul tiple head injuries and injury severity. Few studies have considered the in fluence these variables may have on proper classification of a MTBI and the ir meaning for return-to-play guidelines. This study presents the short-ter m neuropsychological and balance outcomes of four college athletes who sust ained mild head injuries of different severity (grade I, grade II, grade II I and multiple head injured with a grade II based on American Academy of Ne urology guidelines). The results demonstrated that self-report symptoms of concussion were slow to resolve in the grade III and multiple concussed ind ividuals. For neuropsychological testing, Trails A & B, Symbol Digit Modali ties Test and Digits Span Backwards were the most sensitive in identifying differences between the injuries. For balance assessments using the Neuroco m Smart Balance System, the Sensory Organization Test and Reaction Time wer e also important variables in detecting differences among the various injur ies. When these data are used together, it can assist physicians in determi ning safe return-to-play for athletes who sustain MTBI. There are contradin dications in the numerous grading systems and return-to-play guidelines for MTBI. The results from this study provides new evidence which can be assim ilated into a valid grading scale for MTBI sustained in sport.