Concussion Classification: Historical Perspectives and Current Trends

There is still enormous controversy both in the literature and in clinical practice as to how to classify concussed individuals. There is still NO universally accepted concussion grading system. The overall problem with concussion classification is that with the exception of an unconscious athlete (which is a relatively rare case in athletics) or someone who is severely dazed, it is often very difficult to identify who has sustained a concussion and who has not (Cantu, 2006). Despite some advances in clinical practice and research, NO consensus has been reached on how to classify concussion cases nor on proposed universal criteria for a return to sport participation. That said, there are currently three more or less conventionally accepted grading systems which serve to classify concussion based on four criteria: presence/absence of loss of consciousness (LOC), presence/absence and length of injury-related memory problems (amnesia), presence/absence of disorientation/confusion at the time of injury, and the duration of postconcussive symptoms.

A consensus committee of experts released a report in 2002 which recommended that grading systems and their corresponding return to play (RTP) guidelines be abandoned largely because there did not seem to be widespread compliance with RTP due to its conservative nature. Moreover, there still little empirical support for any of the existing return to play criteria. A more recently convened consensus committee that assembled in Prague to revise the recommendations from the 2002 report concluded that a two-grade classification should be used to assist in the management of concussion.


Grade System Sport Participation Retrograde Amnesia Post Concussion Symptom Cerebral Concussion 
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