Sport-Related Concussion

This article provides a comprehensive clinical framework for diagnosing and managing sport-related concussion, which is defined as a mild traumatic brain injury (mTBI) without visible findings on neuroimaging. It emphasizes that symptoms typically arise within 72 hours of injury and are commonly somatic, cognitive, or vestibulo-ocular in nature. While most recover within weeks, approximately one-third of adolescents may experience symptoms persisting beyond four weeks. The article critiques the outdated “cocooning” approach of strict rest and instead recommends early, controlled aerobic activity tailored to individual tolerance, typically starting 24–72 hours after injury. Risk stratification tools such as the 5P Score are discussed for identifying patients likely to experience prolonged symptoms. Management includes vestibular and cervical spine assessments, structured return-to-school and return-to-play protocols, and consideration of psychosocial factors. The article reinforces that recovery is optimized through early clinical follow-up, symptom-guided aerobic activity, academic supports, and multidisciplinary care when necessary.

This article provides a comprehensive clinical framework for diagnosing and managing sport-related concussion, which is defined as a mild traumatic brain injury (mTBI) without visible findings on neuroimaging. It emphasizes that symptoms typically arise within 72 hours of injury and are commonly somatic, cognitive, or vestibulo-ocular in nature. While most recover within weeks, approximately one-third of adolescents may experience symptoms persisting beyond four weeks. The article critiques the outdated “cocooning” approach of strict rest and instead recommends early, controlled aerobic activity tailored to individual tolerance, typically starting 24–72 hours after injury. Risk stratification tools such as the 5P Score are discussed for identifying patients likely to experience prolonged symptoms. Management includes vestibular and cervical spine assessments, structured return-to-school and return-to-play protocols, and consideration of psychosocial factors. The article reinforces that recovery is optimized through early clinical follow-up, symptom-guided aerobic activity, academic supports, and multidisciplinary care when necessary.