Key Points

• Concussion is a neurologic disturbance with variable symptoms, including confusion, headache, vision problems, nausea, balance problems, amnesia, and loss of consciousness.

• Concussion assessment includes evaluation of cranial nerves, pupillary dilation and reactivity, balance and coordination, motor strength, and cognitive function.

• A player should never return to play while symptomatic from a concussion.

• Once asymptomatic, athletes should follow a stepwise and graded exercise program before return to play.

• Neuropsychological testing can aid return-to-play decisions for complex concussions.

In 1966 the Congress of Neurological Surgeons proposed a consensus definition of concussion. Since then, both the definition and our understanding of concussion have been evolving. A concussion is defined as a traumatically induced transient disturbance in neurologic function, usually caused by a direct blow to the head, neck, or face (Aubry et al., 2002).

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