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Concussion in Sports:  Guidelines for the Prevention of Catastrophic Outcome

James P. Kelly, MD; John S. Nichols, MD, PhD; Christopher M. Filley, MD; Kevin O. Lillehei, MD; David Rubinstein, MD; B. K. Kleinschmidt-DeMasters, MD
JAMA. 1991;266(20):2867-2869. doi:10.1001/jama.1991.03470200079039.
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Concussion (defined as a traumatically induced alteration in mental status, not necessarily with loss of consciousness) is a common form of sports-related injury too often dismissed as trivial by physicians, athletic trainers, coaches, sports reporters, and athletes themselves. While head injuries can occur in virtually any form of athletic activity, they occur most frequently in contact sports, such as football, boxing, and martial arts competition, or from high-velocity collisions or falls in basketball, soccer, and ice hockey. The pathophysiology of concussion is less well understood than that of severe head injury, and it has received less attention as a result. We describe a high school football player who died of diffuse brain swelling after repeated concussions without loss of consciousness. Guidelines have been developed to reduce the risk of such serious catastrophic outcomes after concussion in sports.

(JAMA. 1991;266:2867-2869)

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