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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: October 2000 - Volume 10 - Issue 4 - p 235-238
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.

*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.