Grades of Concussion and Management

Grade 1: Transient confusion; no loss of consciousness; resolution of mental-status abnormalities in less than 15 minutes.

Recommended management:

  • Remove the person from contest.
  • Immediate and 5-minute-interval examinations of mental-status abnormalities or post-concussion symptoms, both at rest and with exertion.
  • The person may return to contest if clear of symptoms.

 

Grade 2: Transient confusion; no loss of consciousness; concussion symptoms or mental-status abnormalities with amnesia for longer than 15 minutes.

Recommended management:

  • Remove the person from contest and disallow return to contest that day.
  • Frequent on-site examinations for signs of evolving intracranial abnormality.
  • Evaluation by a trained person the following day.
  • A physician should perform a neurologic examination to clear the person for return to play after a full week of no symptoms, both at rest and with exertion.

 

Grade 3: Any loss of consciousness.

Brief (seconds)
Prolonged (minutes)

Recommended management:

  • Transport to the nearest ER by ambulance if the person is still unconscious or worrisome signs are detected.
  • An immediate neurologic examination should be done, including the appropriate neuro-imaging procedures, when indicated.
  • Hospital admission is indicated if any signs of pathology are detected or if the person's mental status remains abnormal.

 

Headaches are common after grade 1 and 2 injuries.

 

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