Concussion Evaluation

Concussion Evaluation

Mission Brain Injury Center treats concussions just as seriously as severe brain injuries. Concussions are the most common of head injuries and an estimated 300,000 sports-related minor brain injuries occur in the United States each year. The signs and symptoms of a concussion can be subtle but the effects can result in lifetime disabilities if not treated properly.

Symptoms of Concussion on the Field

Any loss of consciousness! Vacant state, slow to answer questions, easily distracted, walking in the wrong direction, unaware of date/time, problems speaking, stumbling, athlete asking the same question multiple times.

Mental Status testing

Neurologic testing

Symptoms of Concussion (minutes to hours after the event) Headache, dizziness, lack of awareness, or nausea/vomiting

Symptoms of Concussion (days to weeks after the event) Persistent headache, light-headed, poor attention, memory problems, easily fatigues, irritable, frustrated easily, problems with bright lights or loud noises, anxiety, depression, or sleep problems. Ask the player's teachers to notify parents of any worsening in school performance!

Call Mission Hospital's Center for Rehab/Sports/Wellness at (949) 364-9637 for a professional follow-up evaluation.


Concussion Grades
Grade 1 Concussion Definition: Transient confusion, no loss of consciousness, and concussion symptoms or mental status abnormalities on examination resolve in less than 15 minutes in time. Athletes commonly refer to this state as having their "bell rung" or been "dinged".
Management: Remove athlete from sports activity and examine immediately and at 5-minute intervals. May return to play within 15 minutes if sideline assessment at rest and with exertion is normal. A second Grade 1 in the same contest eliminates the player from competition that day and returns to play only if no symptoms for one week at rest and with activity.

Grade 2 Concussion Definition: Transient confusion, no loss of consciousness, and concussion symptoms lasting more than 15 minutes.
Management: Remove athlete from sports activity and examine frequently to check for worsening. Do not allow athlete to return to sports activity that day. A trained person should re-examine the athlete to clear for return to play after one week of no symptoms at rest and with exertion. CT/ MRI of brain is rcommended if headache/symptoms persist for more than 1 week. Any abnormality on CT/MRI consistent with swelling or bruising terminates the season for the player. If player has a second grade 2 concussion, he/she may return to play after the player has had 2 weeks of no symptoms at rest and with exertion.

Grade 3 Concussion Definition: Loss of consciousness (LOC) brief or prolonged. Management: Remove from sports activity and transport patient to the nearest ER by ambulance. Neurologic exam should be performed. Athlete may be admitted or sent home. Frequent neuro checks must be done for first 24 hours. A physician should examine the athlete to clear for return to play after one week of no symptoms at rest and with exertion. Follow same CT/MRI guidelines as grade 2. If brief LOC, no play until symptom free for 1 week. If prolonged LOC, no play for 2 weeks. Second Grade 3 - no play for minimum of 1 month or longer.

Reference: Practice Parameters: The Management of Concussion in Sports, Neurology, 1997; 48: pages 581-585.