Recommendations for grading of concussion in athletes

Mild sports-related concussions, in which there is no loss of consciousness , account for >75% of all sports-related brain injury. Universal agreement on concussion definition and severity grading does not exist. Grading syste ms represent expertise of clinicians and researchers yet scientific evidenc e is lacking. Most used loss of consciousness and post-traumatic amnesia as markers for grading concussion. Although in severe head injury these param eters may have been proven important for prognosis, no study has done the s ame for sport-related concussion. Post-concussion symptoms are often the ma in features to help in the diagnosis of concussion in sport. Neuropsycholog ical testing is meant to help physicians and health professionals to have o bjective indices of some of the neurocognitive symptoms. It is the challeng e of physicians, therapists and coaches involved in the care of athletes to know the symptoms of concussion, recognise them when they occur and apply basic, neuropsychological testing to help detect this injury. It is, theref ore, recommended to be familiar with one grading system and use it consiste ntly, even though it may not be scientifically validated. Then good clinica l judgement and the ability to recognise post-concussion signs and symptoms will assure that an athlete never returns to play while symptomatic.