Recovery from mild concussion in high school athletes

Restricted access

Object. A computerized neuropsychological test battery was conducted to evaluate memory dysfunction and self-reporting of symptoms in a group of high school athletes who had suffered concussion.

Methods. Neuropsychological performance prior to and following concussion was compared with the test performance of an age-matched control group. Potentially important diagnostic markers of concussion severity are discussed and linked to recovery within the 1st week of injury.

Conclusions. High school athletes who had suffered mild concussion demonstrated significant declines in memory processes relative to a noninjured control group. Statistically significant differences between preseason and postinjury memory test results were still evident in the concussion group at 4 and 7 days postinjury. Self-reported neurological symptoms such as headache, dizziness, and nausea resolved by Day 4. Duration of on-field mental status changes such as retrograde amnesia and posttraumatic confusion was related to the presence of memory impairment at 36 hours and 4 and 7 days post-injury and was also related to slower resolution of self-reported symptoms. The results of this study suggest that caution should be exercised in returning high school athletes to the playing field following concussion. On-field mental status changes appear to have prognostic utility and should be taken into account when making return-to-play decisions following concussion. Athletes who exhibit on-field mental status changes for more than 5 minutes have longer-lasting postconcussion symptoms and memory decline.

Article Information

Contributor Notes

Address reprint requests to: Mark R. Lovell, Ph.D., University of Pittsburgh Medical Center Sports Medicine Concussion Program, 3200 South Water Street, Pittsburgh, Pennsylvania 15203. email: lovellmr@msx.upmc.edu.

© AANS, except where prohibited by US copyright law.

Headings
References
  • 1.

    American Academy of Neurology: Practice parameter: the management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee. Neurology 48:5815851997American Academy of Neurology: Practice parameter: the management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee. Neurology 48:581–585 1997

    • Search Google Scholar
    • Export Citation
  • 2.

    Cantu RC: Cerebral concussion in sport. Management and prevention. Sports Med 14:64741992Cantu RC: Cerebral concussion in sport. Management and prevention. Sports Med 14:64–74 1992

    • Search Google Scholar
    • Export Citation
  • 3.

    Cantu RC: Second-impact syndrome. Clin Sports Med 17:37441998Cantu RC: Second-impact syndrome. Clin Sports Med 17:37–44 1998

  • 4.

    Collins MWGrindel SHLovell MRet al: Relationship between concussion and neuropsychological performance in college football players. JAMA 282:9649701999Collins MW Grindel SH Lovell MR et al: Relationship between concussion and neuropsychological performance in college football players. JAMA 282:964–970 1999

    • Search Google Scholar
    • Export Citation
  • 5.

    Collins MWLovell MRIverson GLet al: Cumulative effects of concussion in high school athletes. Neurosurgery 51:117511812002Collins MW Lovell MR Iverson GL et al: Cumulative effects of concussion in high school athletes. Neurosurgery 51:1175–1181 2002

    • Search Google Scholar
    • Export Citation
  • 6.

    Collins MWLovell MRMcKeag DB: Current issues in managing sports-related concussion. JAMA 282:228322851999Collins MW Lovell MR McKeag DB: Current issues in managing sports-related concussion. JAMA 282:2283–2285 1999

    • Search Google Scholar
    • Export Citation
  • 7.

    Grindel SHLovell MRCollins MW: The assessment of sport-related concussion: the evidence behind neuropsychological testing and management. Clin J Sport Med 11:1341432001Grindel SH Lovell MR Collins MW: The assessment of sport-related concussion: the evidence behind neuropsychological testing and management. Clin J Sport Med 11:134–143 2001

    • Search Google Scholar
    • Export Citation
  • 8.

    Hinton-Bayre ADGeffen GMGeffen LBet al: Concussion in contact sports: reliable change indices of impairment and recovery. J Clin Exp Neuropsychol 21:70861999Hinton-Bayre AD Geffen GM Geffen LB et al: Concussion in contact sports: reliable change indices of impairment and recovery. J Clin Exp Neuropsychol 21:70–86 1999

    • Search Google Scholar
    • Export Citation
  • 9.

    Hovda DAPrins MBecker DPet al: Neurobiology of concussion in Bailes JELovell MRMaroon JC (eds): Sports-Related Concussion. St. Louis: Quality Medical1999 pp 1251Hovda DA Prins M Becker DP et al: Neurobiology of concussion in Bailes JE Lovell MR Maroon JC (eds): Sports-Related Concussion. St. Louis: Quality Medical 1999 pp 12–51

    • Search Google Scholar
    • Export Citation
  • 10.

    Kelly JP: Traumatic brain injury and concussion in sports. JAMA 282:9899911999Kelly JP: Traumatic brain injury and concussion in sports. JAMA 282:989–991 1999

    • Search Google Scholar
    • Export Citation
  • 11.

    Lang DATeasdale GMMacpherson Pet al: Diffuse brain swelling after head injury: more often malignant in adults than children? J Neurosurg 80:6756801994Lang DA Teasdale GM Macpherson P et al: Diffuse brain swelling after head injury: more often malignant in adults than children? J Neurosurg 80:675–680 1994

    • Search Google Scholar
    • Export Citation
  • 12.

    Levin HSAldrich EFSaydjari Cet al: Severe head injury in children: experience of the Traumatic Coma Data Bank. Neurosurgery 31:4354441992Levin HS Aldrich EF Saydjari C et al: Severe head injury in children: experience of the Traumatic Coma Data Bank. Neurosurgery 31:435–444 1992

    • Search Google Scholar
    • Export Citation
  • 13.

    Lovell MR: Concussion in sports. Br J Sports Med 35:3672001 (Abstract)Lovell MR: Concussion in sports. Br J Sports Med 35:367 2001 (Abstract)

    • Search Google Scholar
    • Export Citation
  • 14.

    Lovell MR: Evaluation of the professional athlete in Bailes JELovell MRMaroon JC (eds): Sports-Related Concussion. St. Louis: Quality Medical1999 pp 200214Lovell MR: Evaluation of the professional athlete in Bailes JE Lovell MR Maroon JC (eds): Sports-Related Concussion. St. Louis: Quality Medical 1999 pp 200–214

    • Search Google Scholar
    • Export Citation
  • 15.

    Lovell MRBurke CW: Concussion in ice hockey in RC Cantu (ed): Neurologic Athletic Head and Spine Injuries. Philadelphia: WB Saunders2000Lovell MR Burke CW: Concussion in ice hockey in RC Cantu (ed): Neurologic Athletic Head and Spine Injuries. Philadelphia: WB Saunders 2000

    • Search Google Scholar
    • Export Citation
  • 16.

    Lovell MRCollins MW: Neuropsychological assessment of the college football player. J Head Trauma Rehabil 13:9261998Lovell MR Collins MW: Neuropsychological assessment of the college football player. J Head Trauma Rehabil 13:9–26 1998

    • Search Google Scholar
    • Export Citation
  • 17.

    Macciocchi SNBarth JTAlves Wet al: Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery 39:5105141996Macciocchi SN Barth JT Alves W et al: Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery 39:510–514 1996

    • Search Google Scholar
    • Export Citation
  • 18.

    Maroon JCLovell MRNorwig Jet al: Cerebral concussion in athletes: evaluation and neuropsychological testing. Neurosurgery 47:6596722000Maroon JC Lovell MR Norwig J et al: Cerebral concussion in athletes: evaluation and neuropsychological testing. Neurosurgery 47:659–672 2000

    • Search Google Scholar
    • Export Citation
  • 19.

    Meeuwisse W (ed): Thematic issue: concussion in sport. Clin J Sport Med 11:1312092001Meeuwisse W (ed): Thematic issue: concussion in sport. Clin J Sport Med 11:131–209 2001

    • Search Google Scholar
    • Export Citation
  • 20.

    Mittenberg WStrauman S: Diagnosis of mild head injury and postconcussion syndrome. J Head Trauma Rehabil 15:7837912000Mittenberg W Strauman S: Diagnosis of mild head injury and postconcussion syndrome. J Head Trauma Rehabil 15:783–791 2000

    • Search Google Scholar
    • Export Citation
  • 21.

    Perrin DHGuskiewicz KM (eds): Special issue: concussion in athletes. J Athl Train 36:2133482001Perrin DH Guskiewicz KM (eds): Special issue: concussion in athletes. J Athl Train 36:213–348 2001

    • Search Google Scholar
    • Export Citation
  • 22.

    Powell JWBarber-Foss KD: Traumatic brain injury in high school athletes. JAMA 282:9589631999Powell JW Barber-Foss KD: Traumatic brain injury in high school athletes. JAMA 282:958–963 1999

    • Search Google Scholar
    • Export Citation
TrendMD
Cited By
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 1091 1082 197
Full Text Views 420 271 24
PDF Downloads 183 121 17
EPUB Downloads 0 0 0
PubMed
Google Scholar