Fourth International Conference on Concussion in Sport Consensus Statement
Last month, the Fourth International Conference on Concussion in Sport issued its consensus statement on concussion in sport. According to the Preamble, this consensus paper is a “revision and update of the recommendations developed following the first (Vienna 2001), second (Prague 2004), and third (Zurich 2008) international consensus conferences on concussion in sports and is based on the deliberations at the Fourth International Conference on Concussion in Sport held in Zurich, November 2012.”
The Statement defines concussion as a “brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces.” It acknowledges that concussion may be caused either by a direct blow to the head, face or neck or elsewhere on the body with an “impulsive” force transmitted to the head. While noting that concussion typically results in a rapid onset of short-lived impairment of neurological function that resolves spontaneously, it acknowledges that symptoms and signs may evolve over a number of minutes to hours. The statement acknowledges that a concussion may or may not involve a loss of consciousness and notes that in some cases “symptoms may be prolonged.”
The Statement indicates that “the application of neuropsychological testing in concussion has been shown to be of clinical value which contributes significant information in concussion evaluation, and that it should be seen as an aid to the clinical decision-making process in conjunction with a range of assessments of different clinical domains and investigational results.
Most importantly, it was unanimously agreed that there should be no return to play by the athlete on the day of concussive injury.
This is an important paper that should be reviewed by all athletes involved in sports as well as coaches, trainers, and physicians.