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American Academy of Neurology Guidelines. The Management of Concussion in Sports (practice parameter). Neurology 1997;48:581-585.

Grades of Concussion

Grade 1: Transient confusion (inattention, inability to maintain a coherent stream of thought and carry out goal directed movements), No loss of consciousness, concussion symptoms or mental status abnormalities on examination resolve in less that 15 minutes.

Grade 2: Transient confusion, No loss of consciousness, concussion symptoms or mental status abnormalities (including amensia) on examination last more than 15 minutes.

Grade 3: Any loss of consciousness either brief (seconds) or prolonged (minutes).

When to Return to Play

Grade of Concussion:

Grade I concussion

Multiple Grade I concussion

Grade 2 concussion

Multiple Grade 2 concussions

Grade 3 Brief LOC

Grade 3 Prolonged LOC

Multiple Grade 3 concussions

Return to Play Only After Being Asymptomatic with Normal Neurological Assessment at Rest and with Exercise:

15 minutes or less

1 week

1 week

2 weeks

1 week

2 weeks

1 month or longer, based on decision of evaluating physician

Using the AAN guidelines, I have found this athlete to have a Grade ___________________ Concussion.

Based on the above guidelines, my recommendation is:

_______ Return on _________________________ (length of time) after symptoms have resolved.

_______ Return only after my follow-up evaluation scheduled for: ______________________________

____________________________________________ __________________________________
Physician's Signature Date