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Updating My Concussion Grading Guidelines

Concussion Grade Now Depends On When Symptoms Clear

In the July-September 2001 issue of the Journal Of Athletic Training devoted exclusively to the subject of concussions in athletes, I proposed some modifications to a set of concussion grading guidelines I first issued in 1986 based on my experience in the fifteen years since.

The following chart compares the two:

Comparison Of 1986 and 2001 Cantu Concussion Grading Guidelines
 

1986 Cantu

2001 Cantu (Evidence Based)

Grade 1 (mild)

 

  • No loss of consciousness (LOC)
  • Posttraumatic amnesia (PTA) lasting less than 30 minutes

 

  • No LOC
  • PTA lasting less than 30 minutes OR
  • Postconcussion signs or symptoms lasting less than 30 minutes

Grade 2 (moderate)

 

  • LOC lasting less than 5 minutes OR
  • PTA lasting longer than 30 minutes but less than 24 hours

 

  • LOC lasting less than 1 minute AND
  • PTA lasting longer than 30 minutes but less than 24 hours OR
  • Postconcussion signs or symptoms lasting longer than 30 minutes but less than 24 hours

Grade 3 (severe)

 

  • LOC lasting longer than 5 minutes OR
  • PTA for more than 24 hours

 

  • LOC lasting longer than 1 minute OR
  • PTA for more than 24 hours OR
  • Postconcussion signs or symptoms lasting longer than 7 days
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