• Melvin Field, Michael W Collins, Mark R Lovell, and Joseph Maroon.
• Department of Neurological Surgery, University of Pittsburgh School of Medicine Center for Sports Medicine, Pennsylvania 15213, USA. fieldm@msx.upmc.edu
• J. Pediatr. 2003 May 1; 142 (5): 546-53.

ObjectiveTo evaluate symptoms and neurocognitive recovery patterns after sports-related concussion in high school and college athletes.Study DesignCollege athletes (n = 371) and high school athletes (n = 183) underwent baseline neuropsychological evaluation between 1997 and 2000. Individuals who received a concussion during athletic competition (n = 54) underwent serial neuropsychologic evaluation after injury and were compared with a noninjured within-sample control group (n = 38). Main outcome measures included structured interview, four memory measures, and Concussion Symptom Scale ratings. Baseline to postinjury change scores and multiple analyses of variance were used to compare recovery curves within and between groups.ResultsHigh school athletes with concussion had prolonged memory dysfunction compared with college athletes with concussion. High school athletes performed significantly worse than age-matched control subjects at 7 days after injury (F = 2.90; P <.005). College athletes, despite having more severe in-season concussions, displayed commensurate performance with matched control subjects by day 3 after concussion. Self-report of postconcussion symptoms by student athletes was not predictive of poor performance on neuropsychologic testing.ConclusionsCaution and systematic evaluation should be undertaken before returning athletes with concussion to competition. Sole reliance on the self-report of the athlete may be inadequate. Preliminary data may suggest a more protracted recovery from concussion in high school athletes.

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