Skip to main content

Advertisement

SpringerLink
Log in

Acute Clinical Recovery from Sport-Related Concussion

  • Review
  • Published:
Neuropsychology Review Aims and scope Submit manuscript

Abstract

Concussion is a highly prevalent injury in contact and collision sports that has historically been poorly understood. An influx of sport-concussion research in recent years has led to a dramatic improvement in our understanding of the injury’s defining characteristics and natural history of recovery. In this review, we discuss the current state of knowledge regarding the characteristic features of concussion and typical acute course of recovery, with an emphasis on the aspects of functioning most commonly assessed by clinicians and researchers (e.g., symptoms, cognitive deficits, postural stability). While prototypical clinical recovery is becoming better understood, questions remain regarding what factors (e.g., injury severity, demographic variables, history of prior concussions, psychological factors) may explain individual variability in recovery. Although research concerning individual differences in response to concussion is relatively new, and in many cases limited methodologically, we discuss the evidence about several potential moderators of concussion recovery and point out areas for future research. Finally, we describe how increased knowledge about the negative effects of and recovery following concussion has been translated into clinical guidelines for managing concussed athletes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. “Prospective” in the context of sport concussion research refers to studies that enroll athletes prior to the sports season (typically during preseason baseline testing) and prior to their period of risk exposure to SRC. Athletes are then followed during one or more sport seasons in order to capture concussions as they occur, allowing for evaluation during the acute recovery period. Because athletes may have participated in contact and collision sports prior to enrollment in a given prospective study, many have prior history of concussion. In well-designed prospective studies, a detailed history is obtained on all athletes at the time of enrollment with respect to the number, acute severity, recovery course and outcome of any concussions predating their involvement in the study, and these data can be used to match concussed and control participants or in moderation analyses. Prospective studies are also typically of a longitudinal design, including detailed evaluations of concussed athletes and matched athlete controls during the acute phase (within 24–48 h of injury) and at several time points to track athletes’ clinical recovery courses.

References

  • Alexander, M. P. (1995). Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology, 45, 1253–1260.

    Article  PubMed  CAS  Google Scholar 

  • Anderson, V., Catroppa, C., Morse, S., Haritou, F., & Rosenfeld, J. (2005). Functional plasticity or vulnerability after early brain injury? Pediatrics, 116, 1374–1382. doi:10.1542/peds.2004-1728.

    Article  PubMed  Google Scholar 

  • Aubry, M., Cantu, R., Dvorak, J., Graf-Baumann, T., Johnston, K., Kelly, J., . . . Concussion in Sport, G. (2002). Summary and agreement statement of the first International Conference on Concussion in Sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries. British Journal of Sports Medicine, 36, 6–10.

  • Barth, J. T., Freeman, J. H., & Winters, J. E. (2000). Management of sport-related concussions. Dental Clinics of North America, 44, 67–83.

    PubMed  CAS  Google Scholar 

  • Barth, J. T., Freeman, J. R., Broshek, D. K., & Varney, R. N. (2001). Acceleration-deceleration sport-related concussion: the gravity of it all. Journal of Athletic Training, 36, 253–256.

    PubMed  PubMed Central  Google Scholar 

  • Bauer, R., & Fritz, H. (2004). Pathophysiology of traumatic injury in the developing brain: an introduction and short update. Experimental and Toxicologic Pathology, 56, 65–73. doi:10.1016/j.etp.2004.04.002.

    Article  PubMed  Google Scholar 

  • Belanger, H. G., & Vanderploeg, R. D. (2005). The neuropsychological impact of sports-related concussion: a meta-analysis. Journal of the International Neuropsychological Society, 11, 345–357.

    Article  PubMed  Google Scholar 

  • Belanger, H. G., Curtiss, G., Demery, J. A., Lebowitz, B. K., & Vanderploeg, R. D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: a meta-analysis. Journal of the International Neuropsychological Society, 11, 215–227. doi:10.1017/S1355617705050277.

    PubMed  Google Scholar 

  • Bijur, P. E., Haslum, M., & Golding, J. (1996). Cognitive outcomes of multiple mild head injuries in children. Journal of Developmental and Behavioral Pediatrics, 17, 143–148.

    PubMed  CAS  Google Scholar 

  • Brehaut, J. C., Miller, A., Raina, P., & McGrail, K. M. (2003). Childhood behavior disorders and injuries among children and youth: a population-based study. Pediatrics, 111, 262–269.

    Article  PubMed  Google Scholar 

  • Broglio, S. P., & Puetz, T. W. (2008). The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: a meta-analysis. Sports Medicine, 38, 53–67.

    Article  PubMed  Google Scholar 

  • Broshek, D. K., Kaushik, T., Freeman, J. R., Erlanger, D., Webbe, F., & Barth, J. T. (2005). Sex differences in outcome following sports-related concussion. Journal of Neurosurgery, 102, 856–863. doi:10.3171/jns.2005.102.5.0856.

    Article  PubMed  Google Scholar 

  • Bruce, J. M., & Echemendia, R. J. (2004). Concussion history predicts self-reported symptoms before and following a concussive event. Neurology, 63, 1516–1518.

    Article  PubMed  Google Scholar 

  • Cantu, R. C. (2001). Posttraumatic retrograde and anterograde amnesia: pathophysiology and implications in grading and safe return to play. Journal of Athletic Training, 36, 244–248.

    PubMed  PubMed Central  Google Scholar 

  • Capruso, D. X., & Levin, H. S. (1992). Cognitive impairment following closed head injury. Neurologic Clinics, 10, 879–893.

    PubMed  CAS  Google Scholar 

  • Carroll, L. J., Cassidy, J. D., Peloso, P. M., Borg, J., von Holst, H., Holm, L., . . . Pepin, M. (2004). Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, Suppl 43, 84–105.

  • Collins, M. W., Grindel, S. H., Lovell, M. R., Dede, D. E., Moser, D. J., Phalin, B. R., . . . McKeag, D. B. (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of the American Medical Association, 282, 964–970.

    Google Scholar 

  • Collins, M. W., Lovell, M. R., Iverson, G. L., Cantu, R. C., Maroon, J. C., & Field, M. (2002). Cumulative effects of concussion in high school athletes. Neurosurgery, 51, 1175–1179.

    Article  PubMed  Google Scholar 

  • Collins, M. W., Iverson, G. L., Lovell, M. R., McKeag, D. B., Norwig, J., & Maroon, J. (2003). On-field predictors of neuropsychological and symptom deficit following sports-related concussion. Clinical Journal of Sport Medicine, 13, 222–229.

    Article  PubMed  Google Scholar 

  • Colvin, A. C., Mullen, J., Lovell, M. R., West, R. V., Collins, M. W., & Groh, M. (2009). The role of concussion history and gender in recovery from soccer-related concussion. American Journal of Sports Medicine, 37, 1699–1704. doi:10.1177/0363546509332497.

    Article  PubMed  Google Scholar 

  • Cosgrove, K. P., Mazure, C. M., & Staley, J. K. (2007). Evolving knowledge of sex differences in brain structure, function, and chemistry. Biological Psychiatry, 62, 847–855. doi:10.1016/j.biopsych.2007.03.001.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Covassin, T., Swanik, C. B., & Sachs, M. L. (2003). Sex differences and the incidence of concussions among collegiate athletes. Journal of Athletic Training, 38, 238–244.

    PubMed  PubMed Central  Google Scholar 

  • Covassin, T., Swanik, C. B., Sachs, M., Kendrick, Z., Schatz, P., Zillmer, E., & Kaminaris, C. (2006). Sex differences in baseline neuropsychological function and concussion symptoms of collegiate athletes. British Journal of Sports Medicine, 40, 923–927. doi:10.1136/bjsm.2006.029496.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Covassin, T., Schatz, P., & Swanik, C. B. (2007). Sex differences in neuropsychological function and post-concussion symptoms of concussed collegiate athletes. Neurosurgery, 61, 345–350. doi:10.1227/01.NEU.0000279972.95060.CB.

    Article  PubMed  Google Scholar 

  • Covassin, T., Stearne, D., & Elbin, R. (2008). Concussion history and postconcussion neurocognitive performance and symptoms in collegiate athletes. Journal of Athletic Training, 43, 119–124. doi:10.4085/1062-6050-43.2.119.

    Article  PubMed  PubMed Central  Google Scholar 

  • Covassin, T., Elbin, R. J., Harris, W., Parker, T., & Kontos, A. (2012). The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion. American Journal of Sports Medicine, 40, 1303–1312. doi:10.1177/0363546512444554.

    Article  PubMed  Google Scholar 

  • Davis, G. A., & Purcell, L. K. (2013). The evaluation and management of acute concussion differs in young children. British Journal of Sports Medicine. Advance online publication. doi:10.1136/bjsports-2012-092132.

  • Davis, D. P., Serrano, J. A., Vilke, G. M., Sise, M. J., Kennedy, F., Eastman, A. B., . . . Hoyt, D. B. (2006). The predictive value of field versus arrival Glasgow Coma Scale score and TRISS calculations in moderate-to-severe traumatic brain injury. Journal of Trauma, 60, 985–990. doi:10.1097/01.ta.0000205860.96209.1c.

    Google Scholar 

  • Delaney, J. S., Lacroix, V. J., Leclerc, S., & Johnston, K. M. (2002). Concussions among university football and soccer players. Clinical Journal of Sport Medicine, 12, 331–338.

    Article  PubMed  Google Scholar 

  • Delaney, J. S., Abuzeyad, F., Correa, J. A., & Foxford, R. (2005). Recognition and characteristics of concussions in the emergency department population. Journal of Emergency Medicine, 29, 189–197.

    Article  PubMed  Google Scholar 

  • DeRoss, A. L., Adams, J. E., Vane, D. W., Russell, S. J., Terella, A. M., & Wald, S. L. (2002). Multiple head injuries in rats: effects on behavior. Journal of Trauma, 52, 708–714.

    Article  PubMed  Google Scholar 

  • Dikmen, S., McLean, A., & Temkin, N. (1986). Neuropsychological and psychosocial consequences of minor head injury. Journal of Neurology, Neurosurgery & Psychiatry, 49, 1227–1232.

    Article  CAS  Google Scholar 

  • DiScala, C., Lescohier, I., Barthel, M., & Li, G. (1998). Injuries to children with attention deficit hyperactivity disorder. Pediatrics, 102, 1415–1421.

    Article  PubMed  CAS  Google Scholar 

  • Dougan, B. K., Horswill, M. S., & Geffen, G. M. (2013). Athletes’ age, sex, and years of education moderate the acute neuropsychological impact of sports-related concussion: a meta-analysis. Journal of the International Neuropsychological Society, 19, 1–17. doi:10.1017/S1355617712001464.

    Article  Google Scholar 

  • Echemendia, R. J., Putukian, M., Mackin, R. S., Julian, L., & Shoss, N. (2001). Neuropsychological test performance prior to and following sports-related mild traumatic brain injury. Clinical Journal of Sport Medicine, 11, 23–31.

    Article  PubMed  CAS  Google Scholar 

  • Ellemberg, D., Henry, L. C., Macciocchi, S. N., Guskiewicz, K. M., & Broglio, S. P. (2009). Advances in sport concussion assessment: from behavioral to brain imaging measures. Journal of Neurotrauma, 26, 2365–2382. doi:10.1089/neu.2009.0906.

    Article  PubMed  Google Scholar 

  • Emerson, C. S., Headrick, J. P., & Vink, R. (1993). Estrogen improves biochemical and neurologic outcome following traumatic brain injury in male rats, but not in females. Brain Research, 608, 95–100.

    Article  PubMed  CAS  Google Scholar 

  • Emery, C. A., & Meeuwisse, W. H. (2006). Injury rates, risk factors, and mechanisms of injury in minor hockey. American Journal of Sports Medicine, 34, 1960–1969. doi:10.1177/0363546506290061.

    Article  PubMed  Google Scholar 

  • Erlanger, D., Kaushik, T., Cantu, R., Barth, J. T., Broshek, D. K., Freeman, J. R., & Webbe, F. M. (2003). Symptom-based assessment of the severity of a concussion. Journal of Neurosurgery, 98, 477–484. doi:10.3171/jns.2003.98.3.0477.

    Article  PubMed  Google Scholar 

  • Esposito, G., Van Horn, J. D., Weinberger, D. R., & Berman, K. F. (1996). Gender differences in cerebral blood flow as a function of cognitive state with PET. Journal of Nuclear Medicine, 37, 559–564.

    PubMed  CAS  Google Scholar 

  • Ewing-Cobbs, L., Prasad, M. R., Kramer, L., Cox, C. S., Jr., Baumgartner, J., Fletcher, S., . . . Swank, P. (2006). Late intellectual and academic outcomes following traumatic brain injury sustained during early childhood. Journal of Neurosurgery, 105(4 Suppl), 287–296. doi:10.3171/ped.2006.105.4.287.

    Google Scholar 

  • Feingold, A. (1994). Gender differences in personality: a meta-analysis. Psychological Bulletin, 116(3), 429–456.

    Article  PubMed  CAS  Google Scholar 

  • Ferrara, M. S., McCrea, M., Peterson, C. L., & Guskiewicz, K. M. (2001). A survey of practice patterns in concussion assessment and management. Journal of Athletic Training, 36, 145–149.

    PubMed  PubMed Central  Google Scholar 

  • Field, M., Collins, M. W., Lovell, M. R., & Maroon, J. (2003). Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. Journal of Pediatrics, 142, 546–553. doi:10.1067/mpd.2003.190.

    Article  PubMed  Google Scholar 

  • Frommer, L. J., Gurka, K. K., Cross, K. M., Ingersoll, C. D., Comstock, R. D., & Saliba, S. A. (2011). Sex differences in concussion symptoms of high school athletes. Journal of Athletic Training, 46, 76–84. doi:10.4085/1062-6050-46.1.76.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gessel, L. M., Fields, S. K., Collins, C. L., Dick, R. W., & Comstock, R. D. (2007). Concussions among United States high school and collegiate athletes. Journal of Athletic Training, 42, 495–503.

    PubMed  PubMed Central  Google Scholar 

  • Giza, C. C., & Hovda, D. A. (2001). The neurometabolic cascade of concussion. Journal of Athletic Training, 36, 228–235.

    PubMed  PubMed Central  Google Scholar 

  • Giza, C. C., Kutcher, J. S., Ashwal, S., Barth, J., Getchius, T. S., Gioia, G. A., . . . Zafonte, R. (2013). Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 80, 2250–2257. doi:10.1212/WNL.0b013e31828d57dd.

  • Goodwin, R. D., & Gotlib, I. H. (2004). Gender differences in depression: the role of personality factors. Psychiatry Research, 126, 135–142. doi:10.1016/j.psychres.2003.12.024.

    Article  PubMed  Google Scholar 

  • Gosselin, N., Theriault, M., Leclerc, S., Montplaisir, J., & Lassonde, M. (2006). Neurophysiological anomalies in symptomatic and asymptomatic concussed athletes. Neurosurgery, 58, 1151–1161. doi:10.1227/01.NEU.0000215953.44097.FA.

    Article  PubMed  Google Scholar 

  • Groswasser, Z., Cohen, M., & Keren, O. (1998). Female TBI patients recover better than males. Brain Injury, 12, 805–808.

    Article  PubMed  CAS  Google Scholar 

  • Guskiewicz, K. M., Weaver, N. L., Padua, D. A., & Garrett, W. E., Jr. (2000). Epidemiology of concussion in collegiate and high school football players. American Journal of Sports Medicine, 28, 643–650.

    PubMed  CAS  Google Scholar 

  • Guskiewicz, K. M., McCrea, M., Marshall, S. W., Cantu, R. C., Randolph, C., Barr, W., . . . Kelly, J. P. (2003). Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. Journal of the American Medical Association, 290, 2549–2555. doi:10.1001/jama.290.19.2549.

    Google Scholar 

  • Halstead, M. E., & Walter, K. D. (2010). Sport-related concussion in children and adolescents. Pediatrics, 126, 597–615. doi:10.1542/peds.2010-2005.

    Article  PubMed  Google Scholar 

  • Hinton-Bayre, A. D., Geffen, G. M., Geffen, L. B., McFarland, K. A., & Friis, P. (1999). Concussion in contact sports: reliable change indices of impairment and recovery. Journal of Clinical and Experimental Neuropsychology, 21, 70–86. doi:10.1076/jcen.21.1.70.945.

    Article  PubMed  CAS  Google Scholar 

  • Hootman, J. M., Dick, R., & Agel, J. (2007). Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. Journal of Athletic Training, 42, 311–319.

    PubMed  PubMed Central  Google Scholar 

  • Iverson, G. L., Lovell, M. R., Smith, S., & Franzen, M. D. (2000). Prevalence of abnormal CT-scans following mild head injury. Brain Injury, 14, 1057–1061.

    Article  PubMed  CAS  Google Scholar 

  • Iverson, G. L., Gaetz, M., Lovell, M. R., & Collins, M. W. (2004). Cumulative effects of concussion in amateur athletes. Brain Injury, 18, 433–443. doi:10.1080/02699050310001617352.

    Article  PubMed  Google Scholar 

  • Jennett, B., & Teasdale, G. (1981). Management of head injuries. Philadelphia: Davis.

    Google Scholar 

  • Jerome, L. (2003). ADHD and driving safety. Canadian Medical Association Journal, 169, 16.

    PubMed  PubMed Central  Google Scholar 

  • Kelly, J. P. (2001). Loss of consciousness: pathophysiology and implications in grading and safe return to play. Journal of Athletic Training, 36, 249–252.

    PubMed  PubMed Central  Google Scholar 

  • Kelly, J. P., & Rosenberg, J. H. (1997). Diagnosis and management of concussion in sports. Neurology, 48, 575–580.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. doi:10.1001/archpsyc.62.6.593.

    Article  PubMed  Google Scholar 

  • Kirkwood, M. W., Yeates, K. O., & Wilson, P. E. (2006). Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population. Pediatrics, 117, 1359–1371. doi:10.1542/peds.2005-0994.

    Article  PubMed  Google Scholar 

  • Lau, B., Lovell, M. R., Collins, M. W., & Pardini, J. (2009). Neurocognitive and symptom predictors of recovery in high school athletes. Clinical Journal of Sport Medicine, 19, 216–221. doi:10.1097/JSM.0b013e31819d6edb.

    Article  PubMed  Google Scholar 

  • Lau, B. C., Kontos, A. P., Collins, M. W., Mucha, A., & Lovell, M. R. (2011). Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? American Journal of Sports Medicine, 39, 2311–2318. doi:10.1177/0363546511410655.

    Article  PubMed  Google Scholar 

  • Lau, B. C., Collins, M. W., & Lovell, M. R. (2012). Cutoff scores in neurocognitive testing and symptom clusters that predict protracted recovery from concussions in high school athletes. Neurosurgery, 70, 371–379. doi:10.1227/NEU.0b013e31823150f0.

    Article  PubMed  Google Scholar 

  • Lincoln, A. E., Caswell, S. V., Almquist, J. L., Dunn, R. E., Norris, J. B., & Hinton, R. Y. (2011). Trends in concussion incidence in high school sports: a prospective 11-year study. American Journal of Sports Medicine, 39, 958–963. doi:10.1177/0363546510392326.

    Article  PubMed  Google Scholar 

  • Lipton, R. B., Scher, A. I., Kolodner, K., Liberman, J., Steiner, T. J., & Stewart, W. F. (2002). Migraine in the United States: epidemiology and patterns of health care use. Neurology, 58, 885–894.

    Article  PubMed  CAS  Google Scholar 

  • Lovell, M. R., & Collins, M. W. (1998). Neuropsychological assessment of the college football player. The Journal of Head Trauma Rehabilitation, 13, 9–26.

    Article  PubMed  CAS  Google Scholar 

  • Lovell, M. R., Iverson, G. L., Collins, M. W., McKeag, D., & Maroon, J. C. (1999). Does loss of consciousness predict neuropsychological decrements after concussion? Clinical Journal of Sport Medicine, 9, 193–198.

    Article  PubMed  CAS  Google Scholar 

  • Lovell, M. R., Collins, M. W., Iverson, G. L., Field, M., Maroon, J. C., Cantu, R., . . . Fu, F. H. (2003). Recovery from mild concussion in high school athletes. Journal of Neurosurgery, 98, 296–301. doi:10.3171/jns.2003.98.2.0296.

  • Macciocchi, S. N., Barth, J. T., Alves, W., Rimel, R. W., & Jane, J. A. (1996). Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery, 39, 510–514.

    PubMed  CAS  Google Scholar 

  • Macciocchi, S. N., Barth, J. T., Littlefield, L., & Cantu, R. C. (2001). Multiple concussions and neuropsychological functioning in collegiate football players. Journal of Athletic Training, 36, 303–306.

    PubMed  PubMed Central  Google Scholar 

  • Makdissi, M., Darby, D., Maruff, P., Ugoni, A., Brukner, P., & McCrory, P. R. (2010). Natural history of concussion in sport: markers of severity and implications for management. American Journal of Sports Medicine, 38, 464–471. doi:10.1177/0363546509349491.

    Article  PubMed  Google Scholar 

  • Marcus, S. M., Young, E. A., Kerber, K. B., Kornstein, S., Farabaugh, A. H., Mitchell, J., . . . Rush, A. J. (2005). Gender differences in depression: findings from the STAR*D study. Journal of Affective Disorders, 87, 141–150. doi:10.1016/j.jad.2004.09.008.

    Google Scholar 

  • McCrea, M. (2001). Standardized mental status testing on the sideline after sport-related concussion. Journal of Athletic Training, 36, 274–279.

    PubMed  PubMed Central  Google Scholar 

  • McCrea, M. A. (2008). Mild traumatic brain injury and postconcussion syndrome: The new evidence base for diagnosis and treatment. New York: Oxford University Press.

    Google Scholar 

  • McCrea, M., Kelly, J. P., Randolph, C., Kluge, J., Bartolic, E., Finn, G., & Baxter, B. (1998). Standardized assessment of concussion (SAC): on-site mental status evaluation of the athlete. The Journal of Head Trauma Rehabilitation, 13, 27–35.

    Article  PubMed  CAS  Google Scholar 

  • McCrea, M., Guskiewicz, K. M., Marshall, S. W., Barr, W., Randolph, C., Cantu, R. C., . . . Kelly, J. P. (2003). Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. Journal of the American Medical Association, 290, 2556–2563. doi:10.1001/jama.290.19.2556.

    Google Scholar 

  • McCrea, M., Hammeke, T., Olsen, G., Leo, P., & Guskiewicz, K. (2004). Unreported concussion in high school football players: implications for prevention. Clinical Journal of Sport Medicine, 14, 13–17.

    Article  PubMed  Google Scholar 

  • McCrea, M., Guskiewicz, K., Randolph, C., Barr, W. B., Hammeke, T. A., Marshall, S. W., & Kelly, J. P. (2009). Effects of a symptom-free waiting period on clinical outcome and risk of reinjury after sport-related concussion. Neurosurgery, 65, 876–882. doi:10.1227/01.NEU.0000350155.89800.00.

    Article  PubMed  Google Scholar 

  • McCrea, M., Guskiewicz, K., Randolph, C., Barr, W. B., Hammeke, T. A., Marshall, S. W., . . . Kelly, J. P. (2013). Incidence, clinical course, and predictors of prolonged recovery time following sport-related concussion in high school and college athletes. Journal of the International Neuropsychological Society, 19, 22–33. doi:10.1017/S1355617712000872.

    Google Scholar 

  • McCrory, P. R., & Berkovic, S. F. (1998). Second impact syndrome. Neurology, 50, 677–683.

    Article  PubMed  CAS  Google Scholar 

  • McCrory, P., Collie, A., Anderson, V., & Davis, G. (2004). Can we manage sport related concussion in children the same as in adults? British Journal of Sports Medicine, 38, 516–519.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • McCrory, P., Johnston, K., Meeuwisse, W., Aubry, M., Cantu, R., Dvorak, J., . . . Schamasch, P. (2005). Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. British Journal of Sports Medicine, 39, 196–204. doi:10.1136/bjsm.2005.018614.

  • McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., & Cantu, R. (2009). Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008. British Journal of Sports Medicine, 43(Suppl 1), i76–i90. doi:10.1136/bjsm.2009.058248.

    Article  PubMed  Google Scholar 

  • McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvorak, J., Echemendia, R. J., . . . Turner, M. (2013). Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine, 47, 250–258. doi:10.1136/bjsports-2013-092313.

  • Meehan, W. P., 3rd, Zhang, J., Mannix, R., & Whalen, M. J. (2012). Increasing recovery time between injuries improves cognitive outcome after repetitive mild concussive brain injuries in mice. Neurosurgery, 71, 885–892. doi:10.1227/NEU.0b013e318265a439.

    Article  PubMed  Google Scholar 

  • Meehan, W. P., 3rd, Mannix, R. C., Stracciolini, A., Elbin, R. J., & Collins, M. W. (2013). Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not. Journal of Pediatrics, 163, 721–725. doi:10.1016/j.jpeds.2013.03.012.

    Article  PubMed  Google Scholar 

  • Mittenberg, W., Wittner, M. S., & Miller, L. J. (1997). Postconcussion syndrome occurs in children. Neuropsychology, 11, 447–452.

    Article  PubMed  CAS  Google Scholar 

  • Ommaya, A. K., & Gennarelli, T. A. (1974). Cerebral concussion and traumatic unconsciousness: correlation of experimental and clinical observations of blunt head injuries. Brain, 97, 633–654.

    Article  PubMed  CAS  Google Scholar 

  • Ommaya, A. K., Goldsmith, W., & Thibault, L. (2002). Biomechanics and neuropathology of adult and paediatric head injury. British Journal of Neurosurgery, 16, 220–242.

    Article  PubMed  CAS  Google Scholar 

  • Powell, J. W., & Barber-Foss, K. D. (1999). Traumatic brain injury in high school athletes. Journal of the American Medical Association, 282, 958–963.

    Article  PubMed  CAS  Google Scholar 

  • (1997) Practice parameter: the management of concussion in sports (summary statement): report of the Quality Standards Subcommittee. Neurology, 48, 581–585.

  • Prichep, L. S., McCrea, M., Barr, W., Powell, M., & Chabot, R. J. (2013). Time course of clinical and electrophysiological recovery after sport-related concussion. The Journal of Head Trauma Rehabilitation, 28, 266–273. doi:10.1097/HTR.0b013e318247b54e.

    Article  PubMed  Google Scholar 

  • Proctor, M. R., & Cantu, R. C. (2000). Head and neck injuries in young athletes. Clinics in Sports Medicine, 19, 693–715.

    Article  PubMed  CAS  Google Scholar 

  • Roof, R. L., & Hall, E. D. (2000a). Estrogen-related gender difference in survival rate and cortical blood flow after impact-acceleration head injury in rats. Journal of Neurotrauma, 17, 1155–1169.

    Article  PubMed  CAS  Google Scholar 

  • Roof, R. L., & Hall, E. D. (2000b). Gender differences in acute CNS trauma and stroke: neuroprotective effects of estrogen and progesterone. Journal of Neurotrauma, 17, 367–388.

    Article  PubMed  CAS  Google Scholar 

  • Roof, R. L., Duvdevani, R., & Stein, D. G. (1993a). Gender influences outcome of brain injury: progesterone plays a protective role. Brain Research, 607, 333–336.

    Article  PubMed  CAS  Google Scholar 

  • Roof, R. L., Zhang, Q., Glasier, M. M., & Stein, D. G. (1993b). Gender-specific impairment on Morris water maze task after entorhinal cortex lesion. Behavioural Brain Research, 57, 47–51.

    Article  PubMed  CAS  Google Scholar 

  • Russell, M. B., Rasmussen, B. K., Thorvaldsen, P., & Olesen, J. (1995). Prevalence and sex-ratio of the subtypes of migraine. International Journal of Epidemiology, 24, 612–618.

    Article  PubMed  CAS  Google Scholar 

  • Ryan, L. M., & Warden, D. L. (2003). Post concussion syndrome. International Review of Psychiatry, 15, 310–316. doi:10.1080/09540260310001606692.

    Article  PubMed  Google Scholar 

  • Schaal, K., Tafflet, M., Nassif, H., Thibault, V., Pichard, C., Alcotte, M., . . . Toussaint, J. F. (2011). Psychological balance in high level athletes: gender-based differences and sport-specific patterns. PLoS One, 6, e19007. doi:10.1371/journal.pone.0019007.

  • Slobounov, S., Slobounov, E., Sebastianelli, W., Cao, C., & Newell, K. (2007). Differential rate of recovery in athletes after first and second concussion episodes. Neurosurgery, 61, 338–344. doi:10.1227/01.NEU.0000280001.03578.FF.

    Article  PubMed  Google Scholar 

  • Slobounov, S., Cao, C., & Sebastianelli, W. (2009). Differential effect of first versus second concussive episodes on wavelet information quality of EEG. Clinical Neurophysiology, 120, 862–867. doi:10.1016/j.clinph.2009.03.009.

    Article  PubMed  PubMed Central  Google Scholar 

  • Snoek, J. W., Minderhoud, J. M., & Wilmink, J. T. (1984). Delayed deterioration following mild head injury in children. Brain, 107, 15–36.

    Article  PubMed  Google Scholar 

  • Swanik, C. B., Covassin, T., Stearne, D. J., & Schatz, P. (2007). The relationship between neurocognitive function and noncontact anterior cruciate ligament injuries. American Journal of Sports Medicine, 35, 943–948. doi:10.1177/0363546507299532.

    Article  PubMed  Google Scholar 

  • Taylor, A. M. (2012). Neuropsychological evaluation and management of sport-related concussion. Current Opinion in Pediatrics, 24, 717–723. doi:10.1097/MOP.0b013e32835a279b.

    Article  PubMed  Google Scholar 

  • Taylor, H. G., Dietrich, A., Nuss, K., Wright, M., Rusin, J., Bangert, B., . . . Yeates, K. O. (2010). Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology, 24, 148–159. doi:10.1037/a0018112.

  • Tierney, R. T., Sitler, M. R., Swanik, C. B., Swanik, K. A., Higgins, M., & Torg, J. (2005). Gender differences in head-neck segment dynamic stabilization during head acceleration. Medicine and Science in Sports and Exercise, 37, 272–279.

    Article  PubMed  Google Scholar 

  • Tierney, R. T., Higgins, M., Caswell, S. V., Brady, J., McHardy, K., Driban, J. B., & Darvish, K. (2008). Sex differences in head acceleration during heading while wearing soccer headgear. Journal of Athletic Training, 43, 578–584. doi:10.4085/1062-6050-43.6.578.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vagnozzi, R., Signoretti, S., Tavazzi, B., Floris, R., Ludovici, A., Marziali, S., . . . Lazzarino, G. (2008). Temporal window of metabolic brain vulnerability to concussion: a pilot 1H-magnetic resonance spectroscopic study in concussed athletes—part III. Neurosurgery, 62, 1286–1295. doi:10.1227/01.neu.0000333300.34189.74.

  • Valovich McLeod, T. C., Bay, R. C., Heil, J., & McVeigh, S. D. (2008). Identification of sport and recreational activity concussion history through the preparticipation screening and a symptom survey in young athletes. Clinical Journal of Sport Medicine, 18, 235–240. doi:10.1097/JSM.0b013e3181705756.

    Article  PubMed  Google Scholar 

  • Zuckerman, S. L., Lee, Y. M., Odom, M. J., Solomon, G. S., Forbes, J. A., & Sills, A. K. (2012a). Recovery from sports-related concussion: days to return to neurocognitive baseline in adolescents versus young adults. Surgical Neurology International, 3, 130. doi:10.4103/2152-7806.102945.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zuckerman, S. L., Solomon, G. S., Forbes, J. A., Haase, R. F., Sills, A. K., & Lovell, M. R. (2012b). Response to acute concussive injury in soccer players: is gender a modifying factor? Journal of Neurosurgery: Pediatrics, 10, 504–510. doi:10.3171/2012.8.PEDS12139.

    PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no financial disclosures or conflicts of interest to report.

Author information

Authors and Affiliations

  1. Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Lindsay D. Nelson & Michael A. McCrea

  2. Department of Psychiatry, University of Illinois at Chicago, Chicago, USA

    Julie K. Janecek

  3. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, USA

    Michael A. McCrea

Authors
  1. Lindsay D. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie K. Janecek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael A. McCrea
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lindsay D. Nelson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nelson, L.D., Janecek, J.K. & McCrea, M.A. Acute Clinical Recovery from Sport-Related Concussion. Neuropsychol Rev 23, 285–299 (2013). https://doi.org/10.1007/s11065-013-9240-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11065-013-9240-7

Keywords

Search

Navigation