LETTER RE: Sports-related concussion: Truth be told

I read with interest the editorial by Hainline et al.¹ commenting on the study by Torres et al.,² who conducted an anonymous survey of sports-related concussion in a collegiate athletic cohort. The Torres et al. survey confirmed what has long been suspected— that athletes frequently avoid reporting concussions to their athletic trainers and the team physician on the sideline. For an athlete, there are obvious conflicts of interest when it comes to reporting a concussion. On one hand, it ensures that he or she receives appropriate and timely medical evaluation and management of the head injury sustained on the field, but it also risks the high likelihood that he or she shall be sidelined until cleared by a medical doctor to return to play. For a professional athlete, the loss of salary, winnings, bonuses, and endorsement income may be prohibitive. For an amateur athlete, it may be the potential loss of an athletic scholarship. The vast majority of sports-related concussions involve no objective loss of consciousness and their detection depends upon accurate reporting of concussive symptoms by the injured athlete. While sideline concussion assessment tests such as Standardized Assessment of Concussion, Balance Error Scoring System, and King-Devick aid in diagnosis, none is exclusively sensitive or specific. Until the above conflicts of interest are adequately addressed, concussions will continue to be underreported by athletes.

Disclosures: N. Sethi serves as Associate Editor for The Eastern Journal of Medicine.

References

1. Hainline B, Dexter WW, DiFiori J. Sports-related concussion: truth be told. Neurol Clin Pract 2013;3:277-278.

2. Torres DM, Galetta KM, Phillips HW, et al. Sports-related concussion: anonymous survey of a collegiate cohort. Neurol Clin Pract 2013;3:279-287.