Grades of Concussion
“There is no such thing as a minor concussion.” – American Academy of Neurology.
The AAN defines concussion as a “alteration of mental status due to a biomechanical forces affecting the brain.” The AAN definition does not require a loss of consciousness. The AAN guidelines, break down grades of concussion:
Grade 1:
- Transient confusion;
- NO loss of consciousness;
- Concussion symptoms clear in less than 15 minutes.
- Grade 2:
- Transient confusion;
- NO loss of consciousness;
- Concussion symptoms or mental status abnormalities last longer than 15 minutes.
- Grade 3:
- Any loss of consciousness, either brief (seconds) or prolonged (minutes).
The AAN guidelines make it clear that permanent brain injury can occur with either Grade 2 or Grade 3 concussion. Thus, it is clear that subtle brain injury can have permanent consequences if the acute symptoms of the concussion continue for more than 15 minutes.
There are still some neuropsychologists and other clinicians that believer in order to have traumatic brain injury and concussion there has to be loss of consciousness. It is such a disservice to the patients to assume this because there is far more research anymore to prove that this just isn’t the case.
A major development in the arena of increasing awareness of the seriousness of all brain injury, has come with the American Academy of Neurology’s, (in conjunction with the Brain Injury Association) development of guidelines for the “Management of Concussion in Sports.”* and their different grades of concussion. We often hear while watching Sunday afternoon football or any sporting event on how a player had suffered a concussion. It wasn’t obvious at the time. They may have been a little shaken up but more often than not they may continue to play which could be causing more damage.
*Source: James P. Kelly, MD, and Jay H. Rosenberg, MD. “Diagnosis and management of concussion in sports”. ©Neurology. 1997. p 575-580.
The Biomechanics of Brain Injury