Current Issues in the Identification, Assessment, and Management of Concussions in Sports-Related Injuries

Younger athletes (below the collegiate level) appear to be at an increased risk for concussions. One of the possible reasons is that youth athletes are sustaining concussions during critical stages in brain development, especially during a time of increased plasticity.  It has been hypothesized that concussions in the developing brain my ultimately impair this plasticity, however it is not yet clear if this impairment is permanent or temporary. The increase in susceptibility to concussions in children and adolescents, compared to adults has been attributed to decreased myelination, a greater head-to-body ratio, thinner cranial bones, which all provide less protection to the developing brain. In respect to gender differences, it is currently unknown the cause but it has been noted that female athletes have an increase in risk for concussions compared to male athletes participating in the same sport. The authors in this study identified that there is a lack of research in concussions and their recovery in relation to specifically female athletes. In regards to assessment, the sideline assessment of concussions is a good gross assessment tool but it is important to have a more comprehensive baseline assessment to then compare to a comprehensive postconcussion assessment. It is then recommended to use serial assessments to demonstrate gradual improvement or deterioration in mental status over time. The authors conclude with further need for concussion research in youth athletes and female athletes of all ages. They also suggest the implementation of a comprehensive concussion management program and promoting mandatory baseline assessments fro all youth athletes at risk. To see full article.