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Is a "Mild" Concussion Really Mild?

Imagine an egg, with its contents rocked back and forth after being hit by an object not quite hard enough to break the shell. Compare this to the human skull and you have concussion: the result of a blow to the head or upper body that can manifest in disorientation, loss of consciousness, and other symptoms -
or nothing at all.

Undiagnosed danger is the alarm sounded in a study by the University of Pittsburgh Medical Center (UPMC). Recent guidelines have suggested that high school athletes with mild or grade 1 concussions, could be returned to play if asymptomatic for 15 minutes, yet the study indicates much longer-lasting repercussions and a measurable decline in neuropsychological functioning from such injury during the first week of recovery.

Forty-three male and female high school athletes (a subgroup of 64 overall) tested with the "ImPACT" tool for neuropsychological performance prior to respective playing seasons; each was later tested two times during the first week of recovery. ImPACT, developed by UMPC researchers, includes assessment of attention, memory, reaction time and information-processing speed. It is also used by the NFL, NHL, MLB, several athletic organizations and approximately 250 high schools in the United States.

A dramatic decrease in memory and an increase in self-reported symptoms was visible in mildly concussed athletes 36 hours after an injury. The group with on-the-field symptoms lasting longer than five minutes retained a 500 percent chance of demonstrating a drop in memory performance.

The study also pointed out the 1.25 million high-school-age contact-sport athletes who incur an estimated 63,000 concussions per year, with mild concussion occurring most frequently. Research suggests - or rather, demands - that this type of injury be looked at more carefully. No longer should the words, "I'm fine," be acceptable to parents and school officials when coming from a "mildly concussed" high school athlete.


Lovell MR, Collins MW, Iverson GL, Johnston KM, Bradley JP. Grade 1 or "ding" concussions in high school athletes. American Journal of Sports Medicine 2004:32, pp47-54.

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