Concussion pearls

1.  See prior posts on sideline assessment and Vienna return to work
2.  Younger athletes (high school) take longer to recover from concussions than college or NFL players on neuropsychologic testing and should be kept out longer accordingly.
3.  the role of multiple concussions in a single season or time between concussions is unclear but under investigation
4.  Clinical head injury in football is strongly related to translational forces.  Rotational forces follow translational forces.  These forces are highest with helmet to helmet hits and backward falls onto ground
5.  Head down strike increases the mass of the striking player 67 % due to alignment of the torso, and thereby increases the severity of concussion accordingly.
6.  Thicker larger and lighter helmets improve the function of prevention and decrease concussion severity
7.  Clinically differentiate early (temporal) injury involving dizziness and later (>40 msec) injuyr involving fornix and midbrain that is more likely associated with memory loss.
8.  The notion of grading concussion the day of the injury may be in error as late cognitive changes are far more important in predicting delayed recovery