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AAN position statement: Physicians must educate, protect athletes from concussions

The American Academy of Neurology statement notes athletes should only be cleared to return to play when they are medically ready.

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The American Academy of Neurology took a firm stance on the management of athletes who have suffered a concussion in a July 9 press release, in which the organization released a new position statement on sports concussion.

The statement asserts doctors have an ethical obligation to only return an athlete to competition after he or she is medically cleared and they should not be influenced by outside sources, including coaches and parents, when making that decision.

The American Academy of Neurology (AAN) has spent years analyzing available research on concussions, according to the press release, and this statement corresponds with the academy’s official guidelines on sports concussion.

Matthew P. Kirschen

Ethics are essential

“With nearly 4 million sports-related concussions in the U.S. each year, it is imperative doctors are educated and protect these athletes who may have sustained a concussion,” stated Matthew P. Kirschen, MD, PhD, lead author of the position statement, in the press release.

The paper was published on behalf of the Ethics, Law, and Humanities Committee, a Joint Committee of the AAN, American Neurological Association, and Child Neurology Society. Kirschen is a neurologist at The Children’s Hospital of Philadelphia and a member of the AAN.

“Concussions can have devastating effects such as short-term impairments in athletes’ cognitive and athletic performance. Repeat concussions have been linked to long-term impairments in brain function, such as problems with learning, memory and behavior,” Kirschen stated in the press release.

Residency training program

In the statement, the AAN called for wider use of baseline cognitive testing for athletes, for the addition of concussion evaluation and management to neurology residency programs, and for development of a national concussion registry to document the incidence and recurrence of concussions at all levels of play.

“These strategies could help identify the threshold at which the number and severity of head injuries leads to irreversible brain injury. They may also help to clarify how concussion risk varies with factors like age, gender, puberty stage and ethnicity so athletes and parents can make informed decisions about playing contact sports,” Kirschen stated.

According to the AAN statement, communication between parents and the physician is also important and physicians should be able to communicate to an athlete’s parents about the potential dangers and long-term effects of a concussion.

AAN officials discussed in the statement how physicians caring for athletes who may have had a concussion have an ethical duty to understand the severity of such injuries and have adequate training and experience in the recognition and evaluation of potential brain injury. – by Robert Linnehan