Sideline Assessment of Concussion

Abstract

A concussion is a transient disturbance in neurologic function due to a force absorbed by the head or body which is transmitted to the brain. An athlete who sustains a concussion can experience abnormal cognition, difficulty with balance, vision changes, memory deficits, and a variety of symptoms including headache, irritability, feeling “in a fog,” or just “not feeling right.” Evaluation of a suspected concussion begins with ruling out catastrophic injuries to the head, neck, and brain which would require transport to an emergency department. Once life- and limb-threatening injuries have been excluded, the athlete should undergo a thorough sideline evaluation of their symptoms, cognitive function, neurologic status, balance, and visual system. This is best accomplished using the Sport Concussion Assessment Tool, 5th edition (SCAT5) as well as 1 or 2 additional scales to test the visual system. While these tools provide information about an athlete with suspected concussion, the final diagnosis relies on the health care provider's medical judgment. This chapter will outline the sideline evaluation and early management of sport-related concussion (SRC).