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Concussions in Soccer
In soccer head injuries are quite common,
head injuries happen to a varying degree in almost all
sports, unfortunately soccer has one of the highest incidence
of head injuries among all team sports. Head injuries that
cause a deficit in brain function are called concussions.
Concussions are graded by severity and are to be managed
with the assistance of a medical doctor. The following
information is to be used only as a guideline.
* The following information is provided
by the Brain Injury Association for more information about
the Management of Concussion in Sports Public Education
please call the Brain Injury Association at (703) 236-6000
ext. 122
Grades
of Concussion in Sports
Grade 1:
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Transient confusion (inattention,
inability to maintain a coherent stream of thought
and carry out goal-directed movements)
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No loss of consciousness
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Concussion symptoms or mental
status abnormalities on examination resolve in
less than 15 minutes (this includes head ache)
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Grade 2:
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Transient confusion
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No loss of consciousness
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Concussion symptoms or mental
status abnormalities (including amnesia) on examination
last more than 15 minutes
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Grade 3:
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Any loss of consciousnes
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Brief (seconds)
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Prolonged (minute
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Management
Recommendations
Grade 1:
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Remove from contest
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Examine immediately and at
5-minute intervals for the development of mental
status abnormalities or post-concussion symptoms
at rest and with exertion
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May return to contest if mental
status abnormalities or post-concussive symptoms
clear within 15 minutes
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Grade 2:
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Remove from contest and disallow
return that day
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Examine on site frequently
for signs of evolving intercranial pathology
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A trained person should reexamine
the athlete the following day
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A physician should perform
a neurologic examination to clear the athlete
for return to play after 1 full asymptomatic
week at rest and with exertion.
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Grade 3:
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Transport the athlete from
the field to the nearest emergency department
by ambulance if still unconscious or if worrisome
signs are detected (with cervical spine immobilization,
if indicated)
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A thorough neurologic evaluation
should be performed emergently, including appropriate
neuroimaging procedures when indicated
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Hospital admission is indicated
if any signs of pathology are detected, or if
mental status of the athlete remains abnormal
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When
to Return to Play
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Grade of Concussion:
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Return to play only after being
asymptomatic with normal neurologic assessment at
rest and with exercise
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Grade 1 Concussion
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15 minutes or less
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Multiple Grade 1 Concussion
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1 week
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Grade 2 Concussion
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1 week
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Multiple Grade 2 Concussions
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2 weeks
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Grade 3 — Brief Loss of Consciousness
(seconds)
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1 week
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Grade 3 — Prolonged Loss of
Consciousness (minutes)
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2 weeks
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Multiple Grade 3 Concussions
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1 month or longer, based on decision
of evaluating physician
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Features
of Concussion Frequently Observed
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Vacant stare (befuddled facial expression)
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Delayed verbal and motor responses
(slow to answer questions or follow instructions)
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Confusion and inability to focus
attention (easily distracted and unable to follow through
with normal activities)
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Disorientation (walking in the wrong
direction; unaware of time date and place)
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Slurred or incoherent speech (making
disjointed or incomprehensible statements)
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Gross observable incoordination (stumbling,
inability to walk tandem/straight line)
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Emotions out of proportion to circumstances
(distraught, crying for no apparent reason)
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Memory deficits (exhibited by the
athlete repeatedly asking the same question that has
already been answered, or inability to memorize and
recall 3 of 3 words or 3 of 3 objects in 5 minutes)
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Any periods of loss of consciousness
(paralytic coma, unresponsiveness to arousal)
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