Concussive Injury

11 Pages 2703 Words

concussions compared with other groups. A discriminant function analysis using neuropsychological testing of athletes 24 hours after acute in-season concussion compared with controls resulted in an overall 89.5% correct classification rate. Conclusions Our study suggests that neuropsychological assessment is a useful indicator of cognitive functioning in athletes and that both history of multiple concussions and LD are associated with reduced cognitive performance. These variables may be detrimentally synergistic and should receive further study. JAMA. 1999;282:964-970 The management of mild traumatic brain injury (MTBI; eg, concussion, defined as a traumatically induced alteration in mental status not necessarily resulting in loss of consciousness) in athletics is currently one of the most compelling challenges in sports medicine. Despite the high prevalence1 and potentially serious outcomes2, 3 associated with concussion, systematic research on this topic is lacking. Many sports medicine practitioners are not satisfied with current return-to-play and treatment options, which do not appear to be evidence based.4-6 There is also little research examining whether long-term cognitive morbidity is associated with concussion. Past research with nonathletes revealed that repeated concussions appear to impart cumulative damage, resulting in increasing severity and duration with a second MTBI occurring within 48 hours.7 No data were presented which addressed more long-term outcomes. Although survey data have shown that a prior history of head injury increases the risk for sustaining subsequent MTBI,8 other potential risk factors associated with sports-related concussion have not been identified. Learning disability (LD), the etiology of which is presumably secondary to central nervous system dysfunction,9 refers to a heterogeneous group of disorders manifested by difficulties in the acquisition and use of listening, speaking, writing, reading...