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A Journal on Psychiatry, Psychology and Psychopharmacology

Official Journal of the Italian Society of Social Psychiatry
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Minerva Psichiatrica 2011 September;52(3):157-69

language: English

Clinical management of concussion in the adolescent athlete: update for the psychiatrist

Tsushima V. G. 1, Tsushima W. T. 2

1 Hawaii Pacific University, Honolulu, Hawaii, USA;
2 Straub Clinic and Hospital, Honolulu, Hawaii, USA


he current empirical knowledge about sports-related concussion, and particularly child and adolescent sports-related concussion, has been developing only in the last few decades. The management of the adolescent athlete who suffers a concussion consists of a series of stages, is multifaceted, and involves a number of professionals. The present paper describes the following stages in the process: 1) preseason assessment and baseline testing; 2) the initial postconcussion assessment, including on-field assessment, evaluations by medical personnel, and neuropsychological screening; 3) follow-up medical investigations (e.g., neuroimaging and balance examination); 4) further psychological interventions; and 5) medical treatment and return-to-play decisions. Clinicians are aware that younger athletes may respond more poorly to mTBI, and that no athlete should return-to-play while symptomatic. It is important to monitor an injured athlete’s recovery over time, with follow-up physical examination and concussion rating scales. Newly developed computerized neuropsychological tests can present practical and valuable data regarding the cognitive functioning of the concussed athlete. Although the empirical data supporting these approaches are still in the early stages of development, these efforts provide conservative strategies in the treatment of adolescent sports-related concussion.

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