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The Nature and Duration of Acute Concussive Symptoms in Australian Football

McCrory, Paul R. PhD*‡; Ariens, Mark MB, BS†; Berkovic, Samuel F. MD*

Clinical Journal of Sport Medicine:
Clinical Investigations

Objective: The purpose of this pilot study was to document the nature and temporal profile of the clinical symptoms of acute sport-related concussion.

Design: Prospective cohort study

Patient Population: A total of 303 elite Australian football players participating in a national competition during a single season.

Outcome Measures: Number and duration of symptoms, digit symbol substitution test (DSST) scores, time of return to play post injury.

Results: A total of 23 concussions were recorded over the course of the 20-week football season. No catastrophic head injuries occurred. Headache was the most common symptom and the most persistent, with 40% of players reporting headache symptoms lasting more than 15 minutes. Ten of the players (43%) returned to sport on the day of the injury with the remainder resuming play within 2 weeks. A low likelihood of return to play on the day of injury was found where 3 or more symptoms were present or where the symptoms lasted more than 15 minutes. These findings were significantly correlated with poor DSST performance.

Conclusions: This pilot study suggests that both the number of postconcussive symptoms and their duration may be used as a measure of injury severity and a guide for return to play.

Author Information

*Department of Medicine (Neurology), University of Melbourne, Austin and Repatriation Medical Centre, Heidelberg, Victoria; †Oakleigh Chargers Football Club, Oakleigh, Victoria; and ‡Olympic Park Sports Medicine Centre, Swan Street, Melbourne, Australia

Received May 27, 1999; accepted August 9, 2000.

Address correspondence and reprint requests to Paul McCrory, PhD, 31 Grosvenor Parade, Balwyn, Victoria 3004, Australia. E-mail:

© 2000 Lippincott Williams & Wilkins, Inc.