Concussion is a form of mild traumatic head injury (TBI) associated with a variety of neurologic signs and symptoms. While historically trivialized in its significance, significant progress has been made in the medical literature and lay understanding of concussion. Severe TBI, long the subject of extensive research, has come under increased scrutiny following experience with blast injuries during the wars in Afghanistan and Iraq. Such experience, grievously earned, has brought significant public attention and funding to the study of head injury. However, for the civilian population, concussion continues to be the most common form of traumatic brain injury, and athletics continues to be the single largest cause of concussion.

Concussion in sports has come under substantial scrutiny as a result of widely publicized injuries in major American sports, particularly football and hockey. Media coverage has increased further as understanding of the related yet distinct syndrome of chronic traumatic encephalopathy (CTE), formerly known as dementia pugilistica or "punch-drunk syndrome", and its proposed mechanism of repeated sub-concussive trauma has increased. While media attention has focused primarily on concussion in professional athletes, the majority of sports-related concussions occur in youth participants.1 With relative unavailability of physicians trained in on-field assessment of concussed athletes relative to professional sports teams, youth athletes are at significant risk for short- and long-term neurologic injury from concussion. This manuscript aims to outline the natural history of sports concussion and review recent updates in on-field assessment and return-to-play guidelines.

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