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Repeat mild traumatic brain injury: how to adjust return to play guidelines.

Robert-Wood Johnson University of Medicine & Dentistry of New Jersey, McCosh Health Center, Princeton, NJ 08540, USA.
Current Sports Medicine Reports (Impact Factor: 1.6). 03/2006; 5(1):15-22.
Source: PubMed

ABSTRACT Determining when it is safe for an athlete to return to play (RTP) after concussion is one of the most difficult decisions facing the team physician. There is significant variability in the evaluation and management of mild traumatic brain injury (mTBI). In the past decade, a tremendous amount of sport-specific research has improved our understanding of mTBI. The advent of neuro-psychologic (NP) testing batteries designed to assess concussive injury has improved the assessment of cognitive dysfunction that occurs in the absence of structural brain abnormalities. The severity of injury is determined by the nature, burden, and duration of symptoms. Athletes must be asymptomatic and have a normal neurologic and cognitive evaluation prior to RTP. Several factors aid in making the RTP decision, including age, the severity of injury, and history of prior mTBIs. Given the potential complications of mTBI, the RTP decision must be made using a thoughtful, individualized process.

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    • "While MTBI is seen frequently in athletes, severity grading and management remain controversial (Gebke, 2002). Evaluation of the concussed athlete is essential before a recommendation to return to play can be made (Putukian, 2006). Often these decisions are made by the certifi ed athletic trainer either on the fi eld or sideline during the game or at post-game follow-up. "
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