The American Academy of Neurology (AAN) has, for the first time since 1998, made major revisions to their standard guidelines for sports-related concussions. The revisions were presented at the annual meeting of the AAN taking place this week in San Diego.
They were also published online in the journal Neurology.
Previous guidelines featured a grading system along with a 10-day waiting period before a player could return to play. These have been eliminated, according to Christopher Giza, MD, of the University of California at Los Angeles and colleagues, whose review found no support for either:
We’ve moved away from the concussion grading system we first established in 1997 and are now recommending [that] concussion and return to play be assessed in each athlete individually. There is no set time line for safe return to play.
Rather, the AAN believes return to play is best regarded flexibly, to be symptom and risk-guided. Other highlights include:
- Athletes should make a slow return to play but only after all acute symptoms have disappeared;
- Licensed professionals with concussion training should be in charge of evaluating concussions;
- Football and rugby, then hockey and soccer, present the biggest concussion risks to boys. Soccer and basketball, to girls
The guidelines don't address chronic traumatic encephalopathy (CTE), the progressive brain disease so often associated with concussion and head trauma, and the reason given for this by review co-author Jeffrey Kutcher, MD, of the University of Michigan in Ann Arbor, is that these are evidence-based guidelines, and CTE is at best anecdotal diagnosis.
Source: AAN
