Concussions in sport

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Concussion, a type of mild traumatic brain injury that is caused by a direct or indirect hit to the head, body, or face is a common injury associated with sports and can affect people of all ages. A concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces".^[1] A concussion should be suspected in any person who falls or has a hit to their face or their body and has a visible sign/clue that they may have a concussion or experiences any symptoms of concussion.^[2] The Concussion Recognition Tool 6 (CRT6) can be used to help non-medically trained people manage sport related concussion on the sideline to ensure that they are directed to the appropriate care.^[2] Symptoms of concussion can be felt right away or appear over the first 1-2 days after an accident. If an athlete has a suspected sport-related concussion they should not return to play that day, not be left alone for the first three hours after their injury, not drive until cleared by a medical professional, and not return to any activity that has a risk of hitting their head or falling (i.e. gameplay or scrimmages) until they have a medical assessment.^[2] If the person has worsening symptoms or any 'red flag symptoms', they need immediate medical attention (urgent care or an emergency department).^[2] Concussions cannot be seen on X-rays or CT scans.^[3]

As of 2012, the four major professional sports leagues in the United States and Canada included policies for managing concussion risk. Sports-related concussions are generally analyzed by athletic training or medical staff on the sidelines using an evaluation tool for cognitive function known as the Sport Concussion Assessment Tool (SCAT), a symptom severity checklist, and a balance test.^[4]

Repeated concussions are known to cause neurological disorders, particularly chronic traumatic encephalopathy (CTE), which in professional athletes has led to premature retirement, erratic behavior and even suicide. The danger of repeated concussions has long been known for boxers and wrestlers. A form of CTE common in these two sports, dementia pugilistica (DP), was first described in 1928. An awareness of the risk of concussions in other sports began to grow in the 1990s, and especially in the mid-2000s, in both the medical and the professional sports communities, as a result of the study of brains of prematurely deceased American football players, that showed an extremely high incidence of CTE (see concussions in American football).