When in doubt, take them out. That is the most important message of the new Berlin Consensus Statement on Concussion in Sport.[1]
Doctors, coaches, trainers, players, and everyone involved in making decisions about players with head injuries must err on the side of caution and remove these players until a specialist can confirm a diagnosis. The consensus statement reflects the wisdom of experts from around the world who came together in Berlin last October to pore over the evidence about sports-related concussions (SRCs) and hash out recommendations. The resulting statement, published online on April 26, 2017, in the British Journal of Sports Medicine, updates and expands on four previous such statements, the oldest of which was published in 2001.
The statement defines SRC as "a traumatic brain injury induced by biomechanical forces." Typically, SRC results from a blow to the head, face, or neck, or elsewhere to the body resulting in impulsive force transmitted to the head.
SRC causes impairment of neurologic function that cannot be explained by drugs or comorbidities. These impairments most often appear quickly, but sometimes evolve over minutes or hours. Usually, no abnormality can be found with standard structural imaging.
The consensus statement lists these possible symptom domains:
