I have been asked to write about concussions from time to time. I attempted a chapter on concussions for a book at some point, over the next few weeks I will post this chapter, as I wrote it, no matter how horrible it is. After all I am not an author, but at least you can take a look. This particular chapter deals with concussions in the sport of football. We all should know this injury can be sustained in any sport. Because football is the biggest draw of sporting eyes I felt it was best to present it in this way. (Part I, Part II & III, Part IV) *All sources will be posted after last portion is up.
Classification of Concussions
Often we hear of “minor” injuries or sometimes they are referred to in degrees; 1st, 2nd, 3rd to give a sense of how bad it is or prognosis of recovery. These classifications not only serve to give the audience a perspective, but they are also necessary for the medical diagnosis and rehabilitation. Over years and years of injury surveillance, record keeping, surgeries, and rehabilitation on injuries of joints and muscles we can clearly define orthopedic injuries with these connotations. Concussion, not so much.
Concussions initially began with a similar “grading” of severity authored by Robert Cantu, MD in 1986[i] adopted by the American College of Sports Medicine and further defined by various other organizations; Colorado Medical Society Guidelines – 1991[ii] (adopted by the NCAA), American Academy of Neurology – 1997[iii]. The issue as time went on was there was not a consensus of which grading system was the appropriate practice of care, the problem existed until three years ago when most health care providers began to accept and conform to The 3rd International Conference on concussion in sport, held in Zurich, Switzerland[iv]. The key word being “most” as this information, widely accepted and worked on by the leaders in this issue, has not been seen or adhered to by physicians.
The consensus statement[v] was built upon the two previous meetings in Vienna (2001) and Prague (2004) as the exclusive panel began the process of trying to obtain a common ground on the concussion epidemic. The take home message from this in terms of classification is that a concussion is a concussion. Due to the varying factors and injury evolution differing from individual to individual the experts determined that “mild”, “moderate”, “severe”, “simpe”, and “complex” should not be used to diagnose or classify the actual injury. To this day doctors, players, athletic trainers continue to use those terms when describing the injury, which is improper.
There is nothing mild or simple about a concussion, this injury is a significant insult to the brain and its function; therefore a concussion is a concussion.
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