Inconsistent diagnosis for sports-related concussions lead to miscommunications

Boston researchers have found that the definition of a concussion varies across different sports and even across disciplines, which can lead to miscommunication about patient outcomes.

“The term ‘concussion’ means different things to different people and it is not yet clear that the signs and symptoms we now use to make a diagnosis will ultimately prove to be the most important pieces of this complicated puzzle,” Ann-Christine Duhaime, MD, lead author and director of the Pediatric Brain Trauma Lab at Massachusetts General Hospital, stated in a press release.

Dehaime and colleagues studied more than 486,000 recorded head impacts from 450 students at four universities on three football teams, two women’s hockey teams and two men’s school hockey teams, according to the abstract. The researchers equipped athletes with helmets that measured location, frequency and magnitude of impacts to the head during practice, scrimmages and games.

While concussions were diagnosed 48 times in 44 patients, only 31 concussions were associated with clear impacts. Researchers noted no clearly associated impact or less measured head acceleration and deceleration than was expected in 17 cases. An immediate concussion diagnosis was made in only six cases, according to the abstract.

Patients most commonly reported symptoms of dizziness, headache and mental cloudiness, but many patients did not experience the symptoms for several hours after the game.

“A lot of work is needed before we can understand to what extent patients’ reported symptoms – compared to such factors as the actual force imparted to the brain, previous head injuries and genetic background – influence the eventual consequences of repeated head impacts, consequences that may vary from patient to patient,” Duhaime said.

Reference:

Duhaime A-C, Beckwith JG, Maerlender AC, et al. Spectrum of acute clinical characteristics of diagnosed concussions in college athletes wearing instrumented helmets. J Neurosurg. 2012. Published online ahead of print Oct. 2, 2012. doi:10.3171/2012.8.JNS112298.

Disclosure: Duhaime has no relevant financial disclosures.