We conduct neuropsychological baseline screenings of athletes in high school,
junior high, and elementary school. A recent meta-analysis of research
described in “Sports Medicine” (2008; see download of this article on this
page) found that 1.6 to 3.8 million sport-related concussions occur each year in
the US, with 250,000 concussions occurring in high school football.
Concussions are also common in soccer. Once an athlete sustains a
concussion, she/he is more likely to sustain a second concussion. All NFL
football players and NHL hockey players are required to receive baseline
neuropsychological screenings, but screenings are also highly recommended
for athletes in all grade levels.

Neuropsychological baseline screenings assess the cognitive domains most
susceptible to concussion. Screenings assess the following domains (which are
highly sensitive to the effects of concussion):
*Verbal learning/memory
*Visual-spatial learning/memory
*Visual-motor processing speed
*Visual-motor scanning and shifting attention
*Auditory attention span/working memory
*Rapid verbal retrieval
*Post-Concussion Symptoms Scale (self-reports of physical, cognitive,
and emotional symptoms often associated with concussion)

Parents also complete a questionnaire ahead of time, and Dr. Baker provides
parents with a report containing baseline test scores. Unless baseline testing is
conducted prior to a concussion, it is difficult to determine whether cognitive
difficulties are due to an injury or longstanding weaknesses. If an athlete
sustains a concussion within practice or a game, he/she should receive a re-
evaluation with 2-3 days to assess potential changes in cognitive functioning
since baseline testing. If there has been a statistically significant decline in
scores, she/he is advised not to return to playing until cognitive status has
returned to baseline. This information is useful to physicians, athletic trainers,
and other medical personnel in determining safe return to play. One of the
reasons it is so important to monitor cognitive status following concussion is to
prevent a rare condition referred to as “Second Impact Syndrome” (SIS),
which involves rapid swelling of the brain when an individual sustains a second
concussion prior to resolution of symptoms from an earlier concussion. SIS is
often a fatal condition, and almost all individuals who survive SIS are severely
disabled. Most cases of SIS occur in young people, and are most common in
adolescents ages 12-18 years old. Also, baselines results are useful if the athlete
sustains another neurological injury/illness in the future to determine the level of
change that has occurred. Screenings typically require 35-45 minutes to
Sports Concussion Articles
Young Athletes and Head Injury
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