Self-reported symptoms are "among the more obvious and recognizable ways to assess the effects of concussion," and are referenced in many of the concussion grading scales."

If any of the following symptoms or problems is present, a head injury should be suspected and appropriate management, including monitoring for deterioration begun.

Symptom	Time of Injury	2-3 hours post-injury	24 hours post-injury	48 hours post-injury	72 hours post-injury
Unaware of period, opposition, score of game		N/A	N/A	N/A	N/A
Amnesia
Confusion
Loss of Consciousness impaired conscious state
Headache
"Pressure in head"
Neck pain
Poor balance, coordination or unsteady gait or dizziness
Nausea
Feel "dinged", stunned or "dazed"
Feel "in a fog"
Feel "slowed down"
Concussive convulsion/impact seizures
Depression
Drowsiness
Excess Sleep
Fatigue or low energy
Inappropriate emotions (e.g. laughing or crying) or personality change/more emotional than usual
Inappropriate playing behavior (e.g. running the wrong direction)
Irritability or emotional changes
Loss of Orientation
Nervous or anxious
Numbness/tingling
Memory problems
Poor concentration, easily distracted
Hearing problems/ringing in ears
Sadness
Sensitivity to noise
Significantly decreased playing ability
Slow to answer questions or follow directions
Slurred speech
Trouble falling asleep/Sleep Disturbance
Sleeping more than usual
Vacant stare/glassy eyed
Vision problems (seeing stars or flashing lights, blurred/double vision, sensitivity to light)
Vomiting

In lieu of simply checking each symptom that is present, the athlete can be asked to grade or score the severity of the symptom on a scale of 0 to 6, with 0=not present 1=mild, 3=moderate, and 6=most severe. This is the approach used for self-assessment by the athlete on the Sport Concussion Assessment Tool

This checklist should be used not only for the initial evaluation but for each subsequent follow-up assessment until all signs and symptoms have cleared both at rest and with physical exertion.

An athlete should not be allowed to return to play if he is still experiencing any of these symptoms, and, based on current guidelines, such as that issued after the 2nd International conference on concussion in sport held in Prague in 2004, the athlete should be fully symptom free for at least 7 days before returning to play.

¹ Guskiewicz, Kevin, et al. "National Athletic Trainers' Association Position Statement: Management of Sport-Related Concussion," Journal of Athletic Training, 2004; 39(3): 280-297.

Article updated December 26, 2007
Author: Lindsay Barton
©: MomsTeam.com, Inc.

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