The issue of determining the readiness of athletes to return to action
following a head injury has received recognition as a major public health
issue.1 Concern over the health of the athlete
with a concussion has prompted the development of parameters to guide management
and return-to-play issues. These guidelines, however, have been controversial
within the sports medicine community.2 The
controversy appears to result from a lack of scientific foundation, and thus
an arbitrary delineation of concussion grades and return-to-play criteria.
This article critically examines concussion management guidelines and makes
recommendations for the development of practical strategies. Two actual concussion
cases illustrate these issues.
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