Clinical features and early detection of sport-related concussion

Aim Athletes who suffer sport-related concussions but continue playing have a high probability of experiencing more severe symptoms with any subsequent concussion. This study used data from the authors' clinical department to retrospectively investigate the clinical characteristics of sport-related concussion and factors associated with delays in examinations. Methods The study included 38 patients with sport-related concussions who were treated at the authors' hospital. The sports during which the injuries occurred, occasions of injury, factors affecting the time from injury until examination at hospital, and prognoses were evaluated retrospectively. Results Sport-related concussions most frequently occurred in rugby and judo, where tackling, throwing, and other types of physical contact can result in impacts to the head region at high angular or linear velocity with acceleration. Some subjects showed consciousness disturbance and/or clear subjective symptoms immediately after the injury and were therefore examined at the hospital rapidly. However, other subjects who suffered amnesia or less obvious symptoms continued to play after the injury and had delayed examinations. In addition, there was a tendency for examinations to be delayed when an on-site physician was present. Conclusions In contact sports where injury-resulting events occur, such as impacts to the head at high angular or linear velocity with acceleration, athletes should be immediately withdrawn from play and evaluated for concussion, even if there are no obvious head injuries or symptoms. The immediate ascertainment of symptoms after physical contact would improve the rapid detection of sport-related concussion.