Abstract
Mild traumatic brain injuries are common at all levels of athletic competition. Although once considered a “routine part of the game,” a significant amount of attention has recently been placed on these injuries at the professional, college, and high school levels. This paper reviews the epidemiology of sports-related brain injuries, the pathophysiology of the injuries, and the role of neuropsychology in this newly emerging area. Issues related to the adequacy of neuropsychological test instruments and approaches are discussed in light of future directions for research.
We’re sorry, something doesn't seem to be working properly.
Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.
REFERENCES
Abreau, F., Templer, D., Schuyler, B., and Hutchison, H. (1990). Neuropsychological assessment of soccer players. Neuropsychology 4: 175–181.
Adams, J. H., Graham, D. I., Gennarelli, T. A., and Maxwell, W. J. (1991). Diffuse axonal injury in non-missile head injury. Journal of Neurology, Neurosurgery, and Psychiatry 54(6): 481–483.
Adams, J. H., Graham, D. I., Murray, L. S., and Scott, G. (1982). Diffuse axonal injury due to non-missile injury in humans: An analysis of 45 cases. Annals of Neurology 12: 557–563.
Anderson, B. J., and Marmarou, A. (1989). Isolated stimulation of glycolysis following traumatic brain injury. In Hoff, J. T. B., and Betz, A. L. (eds.), Intracranial Pressure, Vol. 7, Springer-Verlag, Berlin, pp. 575–580.
Barnes, B. C., Cooper, L., Kirkendall, D. T., McDermott, T. P., Jordan, B. D., and Garrett, W. E. (1998). Concussion history in elite male and female soccer players. American Journal of Sports Medicine 26(3): 433–438.
Barth, J. T., Macciocchi, S. N., Giordani, B., Rimel, R., Jane, J. A., and Boll, T. J. (1983). Neuropsychological sequela of minor head injury. Neurosurgery 13(5): 529–533.
Barth, J. T., Alves, W. M., Ryan, T. V., Macciocchi, S. N., Rimel, R. W., Jane, J. A., and Nelson, W. E. (1989). Mild head injury in sports: Neuropsychological sequelae and recovery of function. In Levin, H. S., Eisenberg, H. M., and Benton, A. L. (eds.), Mild Head Injury, Oxford University Press, New York, pp. 257–275.
Barth, J. T., Varney, R., Ruchinskas, R., and Francis, J. (1999). Mild head injury: The new frontier in sports medicine. In Varney, N., and Roberts, R. (eds.), Evaluation and Treatment of Mild Traumatic Brain Injury, Erlbaum, Mahwah,NJ, pp. 81–98.
Batchelor, J., Harvey, A. G., and Bryant, R. A. (1995). Stroop colour word test as a measure of attention deficit following mild head injury. The Clinical Neuropsychologist 9(2): 180–186.
Benedict, R. H. (1989). The effectiveness of cognitive remediation strategies for victims of traumatic head-injury: A review of the literature. Clinical Psychology Review 9(5): 605–626.
Bergsneider, M., Hovda, D. A., Shalmon, E., Kelly, D. F., Vespa, P., Martin, N. A., Phelps, M., McArthur, D. L., Kraus, J. F., and Becker, D. P. (1997). Cerebral hyperglycolysis following severe human traumatic brain injury: A positron emission tomography study. Journal of Neurosurgery 86(2): 241–251.
Bigler, E. (1999). In Varney, N., and Roberts, R. (eds.), Evaluation and Treatment of Mild Traumatic Brain Injury, Lawrence Erlbaum, Mahwah, NJ.
Bohnen, N., Jolles, J., and Twijnstra, A. (1992). Neuropsychological deficits in patients with persistent symptoms six months after mild head injury. Neurosurgery 30(5): 692–696.
Bohnen, N., Twijnstra, A., and Jolles, J. (1991). Performance in the Stroop color word test in relationship to the persistence of symptoms following mild head injury. Acta Neurologica Scandinavica 85: 116–121.
Breton, F., Pincemaille, Y., Tarriere, C., and Renault, B. (1990). Event-related potential assessment of attention and the orienting reaction in boxers before and after a fight. Biological Psychology 31: 57–71.
Brooks, J. (1999). Aprogram for the assessment of concussion of the high school athlete. Paper presented at the Sports Related and Nervous System Injuries Conference, Orlando, FL.
Brooks, N., Kupshik, G., Wilson, L., Galbraith, S., and Ward, R. (1987). A neuropsychological study of active amateur boxers. Journal of Neurology, Neurosurgery, and Psychiatry 50: 997–1000.
Busse, E. W., and Silverman, A. J. (1952). Electroencephalographic changes in professional boxers. Journal of the American Medical Association 149: 1522–1525.
Canadian Academy of Sport Medicine Concussion Committee. (2000). Guidelines for assessment and management of sport-related concussion. Clinical Journal of Sport Medicine 10: 209–211.
Cantu, R. (1988). When to return to contact sports after a cerebral concussion. Sports Medicine Digest 10: 1, 2.
Cantu, R. C., and Voy, R. (1995). Second impact syndrome: A risk in any contact sport. The Physician and Sports Medicine 23(6): 114.
Casson, I. R., Sham, R., Campbell, E. R., Tarlau, M., and DiDomenico, A. (1982). Neurological and CT evaluation of knocked out boxers. Journal of Neurology, Neurosurgery, and Psychiatry 45(2): 170–174.
Casson, I. R., Siegel, O., Sham, R., Campbell, E. A., Tarlau, M., and DiDomenico, A (1984). Brain damage in modern boxers. Journal of the American Medical Association 251: 2663–2667.
Collins, M. W., Grindel, S., Dede, D., McKeag, D., Moser, D., Phalin, B., Day, A., Indelicato, P., Nicholette, G., Wasik, M., Walser, M., Patrick, C., Horodyski, M. B., Sears, S., Cordry, D., Klotz-Daugherty, M., Nogle, S., and Lovell, M. (1998). Neuropsychological testing in college football: A multi-center analysis of mild brain trauma. Paper presented at the meeting of the Sports Related Concussion and Nervous System Injuries, Orlando, FL.
Collins, M., Grindel, S., Lovell, M., Dede, D., Moser, D., Phalin, B., Nogle, S., Wasik, M., Cordry, D., Daugherty, M., Sears, S., Nicolette, G., Indelicato, P., and McKeag, D. (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of the American Medical Association 282: 964–970.
Collins, M. W., Lovell, M. R., and McKeag, D. B. (1999). Current issues in managing sports-related concussion. Journal of the American Medical Association 282: 2283–2285.
Colorado Medical Society. (1991). Report of the Sports Medicine Committee: Guidelines for the management of concussion in sports (revised), Colorado Medical Society, Denver.
Cosgrove, J. W., Atack, J. R., and Rapoport, S. I. (1987). Regional analysis of rat brain proteins during senescence. Experimental Gerontology 22: 187–198.
Cremona-Meteyard, S. L., and Geffen, G. M. (1994). Persistent visuospatial attention deficits following mild head injury in Australian rules football players. Neuropsychologia 32(6): 649–662.
Davidoff, D. A., Kessler, H. R., Laibstain, D. G., and Mark, V. H. (1988). Neurobehavioral sequelae of minor head injury: A consideration of post-concussive syndrome versus post-traumatic stress disorder. Cognitive Rehabilitation 6(2): 8–13.
Davis, R. L., Mullen, N., Makela, M., Taylor, J. A., Cohen, W., and Rivara, F. P. (1994). Cranial computed tomography scans in children after minimal head injury with loss of consciousness. Annals of Emergency Medicine 24(4): 640–645.
Deb, S., Lyons, I., and Koutzoukis, C. (1999). Neurobehavioural symptoms one year after a head injury. British Journal of Psychiatry, 174(April), 360–365.
Delany, J. S., Lacroix, V. J., Leclerc, S., and Johnston, K. M. (2000). Concussions during the 1997 Canadian Football League season. Clinical Journal of Sport Medicine 10: 9–14.
Dick, R. W. (1994). NCAA Injury Surveillance System: 1984-1991. National Collegiate Athletics Association-Sports Sciences, Overland Park, KS.
Dick, R. W. (1997). A summary of head and neck injuries in collegiate athletics using the NCAA Injury Surveillance System. In Hoerner, E. F. (ed.), Head and Neck Injuries in Sports, American Society for Testing and Materials, Philadelphia.
Dick, R. W. (1999). NCAA Injury Surveillance System: 1997-98. National Collegiate Athletics Association-Sports Sciences, Overland Park, KS.
Echemendia, R. J. (1997). Neuropsychological assessment of college athletes: The Penn State Concussion Program. Paper presented at the meeting of the National Academy of Neuropsychology, Las Vegas, NV.
Echemendia, R. J., Mackin, R. S., and Coyle, J. T. (2001b). The effect of presentation rate on digit span scores.
Echemendia, R. J., Putukian, M., Mackin, R. S., Julian, L., and Shoss, N. (2001a). Neuropsychological test performance prior to and following sports-related mild traumatic brain injury. Clinical Journal of Sport Medicine 11: 23–31.
Feriencik, K. (1979). Trends in Ice Hockey injuries: 1965-1977. The Physician and Sports Medicine 7(2): 81–84.
Gennarelli, T. A. (1986). Mechanisms and pathophysiology of cerebral concussion. Journal of Head Trauma Rehabilitation 1(2): 23–29.
Gennarelli, T. A. (1993). Cerebral concussion and diffuse brain injuries. In Cooper, P. R. (ed.), Head Injury, Williams & Wilkins, Baltimore, pp. 137–158.
Gennarelli, T. A., and Thibault, L. E. (1982). Biomechanics of acute subdural hematoma. Journal of Neurotrauma 22: 680–686.
Gerberich, S. G., Priest, J. D., Boen, J. R., Straub, C. P., and Maxwell, R. E. (1983). Concussion incidences and severity in secondary school varsity football players. American Journal of Public Health 73(12): 1370–1375.
Graham, D., and Gennarelli, T. A. (1997). Trauma. In Graham, D. I., and Lantos, P. L. (eds.), Greenfield's Neuropathology, Oxford University Press, New York, pp. 197–262.
Gronwall, D. (1986). Rehabilitation programs for patients with mild head injury: Components, problems, and evaluation. Journal of Head Trauma Rehabilitation 1(2): 53–62.
Gronwall, D., and Wrightson, P. (1974). Delayed recovery of intellectual function after mild head injury. The Lancet, September(Saturday 14), 605–609.
Gronwall, D., and Wrightson, P. (1975). Cumulative effect of concussion. The Lancet, November(Saturday 22), 995–997.
Grote, C., and Donders, J. (2000). Comment on Matser, et al. brain injury in amateur soccer players. Journal of the American Medical Association 283: 882, 883.
Guskiewicz, K. M., Riemann, D., Perrin, D. H., and Nashner, L. M. (1997). Alternative approaches to the assessment of mild head injury in athletes. Medicine and Science in Sports and Exercise 29: 213–221.
Guskiewicz, K. M., Weaver, N. L., Padua, D. A., and Garrett, W. E. (2000). Epidemiology of concussion in collegiate and high school football players. American Journal of Sports Medicine 28: 643–650.
Higgins, G. E. (1999). Clinical interventions with mild head injury patients. In VandeCreek, L., and Jackson, T. L. (eds.), Innovations in Clinical Practice: A Sourcebook, Vol. 17, Professional Resource Press/Professional Resource Exchange, Sarasota, FL, pp. 153–167.
Hinton-Bayre, A. D., Geffen, G., and McFarland, K. (1997). Mild head injury and speed of information processing: A prospective study of professional rugby league players. Journal of Clinical and Experimental Neuropsychology 19(2): 275–289.
Ho, M. R., and Bennett, T. L. (1997). Efficacy of neuropsychological rehabilitation for mild-moderate traumatic brain injury. Archives of Clinical Neuropsychology 12(1): 1–11.
Hovda, D. A. (1996). Metabolic dysfunction. In Narayan, R. K., Wilberger, J. E., and Povlishock, J. T. (eds.), Neurotrauma, McGraw-Hill, New York, pp. 1459–1478.
Hovda, D. A., Katayama, Y., Yoshino, A., Kawamata, T., and Becker, D. P. (1992). Pre-or postsynaptic blocking of glutamergic functioning prevents the increase in glucose utilization following concussive brain injury. In Globus, W. D. (ed.), The Role of Neurotransmitters in Brain Injury, Plenum Press, New York, pp. 327–332.
Hovda, D. A., Prins, M., Becker, D. P., Lee, S., Bergsneider, M., and Martin, N. A. (1999). Neurobiology of Concussion. In Bailes, J. E., Lovell, M. R., and Maroon, J. C. (eds.), Sports-Related Concussion, Quality Medical Publishing, St. Louis, pp. 12–51.
Hovda, D. A., Yoshino, A., Kawamata, T., Katayama, Y., Fineman, I., and Becker, D. P. (1990). The increase in local cerebral glucose utilization following fluid percussion brain injury is prevented with kynurenic acid and is associated with an increase in calcium. Acta Neurochir Supplement 51: 331–333.
Infusini, M. (1995). Minor head injury from devastation to recovery. Journal of Cognitive Rehabilitation 12(1): 4, 5.
Jacewicz, M., Brint, S., Tanabe, J., Wang, X. J., and Pulsinelli, W. A. (1990). Nimodipine pretreatment improves cerebral blood flow and reduces brain edema in conscious rats subjected to focal cerebral ischemia. Journal of Cerebral Blood Flow Metabolism 10: 903–913.
Jacobson, R. R. (1995). The post-concussional syndrome: Physiogenesis, phychogenesis, and malingering. An integrative model [Review]. Journal of Psychosomatic Research 39(6): 675–693.
Jordan, B. D. (1987). Neurologic aspects of boxing. Archives of Neurology 44: 453–459.
Jorgensen, U., and Schmidt-Olsen, (1986). The epidemiology of ice hockey injuries. British Journal of Sports Medicine 20: 7–9.
Kaplan, H. A., and Browder, J. (1954). Observations on the clinical and brain wave patterns of professional boxers. Journal of the American Medical Association 156: 1138–1144.
Kaste, M., Kuurne, T., Vilkki, J., Katevuo, K., Sainio, K., and Meurala, H. (1982). Is chronic brain damage in boxing a hazard of the past? Lancet 2(8309): 1186–1188.
Kelly, J. P., Nichols, J. S., Filley, C. M., Lillehei, K. O., Rubinstein, D., Kleinschmidt-DeMasters, B. K. (1991). Concussion in sports: Guidelines for the prevention of catastrophic outcome. Journal of the American Medical Association 266(20): 2867–2869.
Kelly, J. P., and Rosenberg, J. H. (1997). The diagnosis and management of concussion in sports. Neurology 48: 575–580.
Kross, R., Ohler, K., and Barolin, G. S. (1983). Effect of heading in soccer on the head-a quantifying EEG study of soccer players [German]. EEG-EMG Zetschrift fur Elektroenzephalographi Electromyographie und Verwandte Gebiete 14(4): 209–212.
Levin, H. S., Amparo, E., Eisenberg, H. M., Williams, D. H., High, W. M., McArdle, C. B., and Weiner, R. L. (1987a). Magnetic resonance imaging and computerized tomography in relation to the neurobehavioral sequelae of mild and moderate head injuries. Journal of Neurosurgery 66: 706–713.
Levin, H. S., Eisenberg, H. M., and Benton, A. L. (eds.). (1989). Mild Head Injury, Oxford University Press, New York.
Levin, H. S., Mattis, S., Ruff, R. M., Eisenberg, H. M., Marshall, L. F., and Tabaddor, K. (1987b). Neurobehavioral outcome following minor head injury: A 3-center study. Journal of Neurosurgery 66: 234–243.
Lezak, M. (1995). Neuropsychological Assessment, Oxford University Press, New York.
Lovell, M. R., and Collins, M. W. (1998). Neuropsychological assessment of the college football player. Journal of Head Trauma Rehabilitation 13(2): 9–26.
Lovell, M. R., and Echemendia, R. J. (1999). NHL Rink-Side Evaluation of Concussion, Author, Pittsburgh, PA.
Lovell, M. R., Iverson, G., Collins, M. W., McKeag, D., and Maroon, J. (1999). Does loss of consciousness predict neuropsychological decrements after concussion? Clinical Journal of Sport Medicine 9: 193–198.
MacFlynn, G., Montgomery, E. A., Fenton, G. W., and Rutherford, W. (1984). Measurement of reaction time following minor head injury. Journal of Neurology, Neurosurgery, and Psychiatry 47: 1326–1331.
Maroon, J. C., Lovell, M. R., Norwig, J., Podell, K., Powell, J. W., and Hartl, R. (2000). Cerebral concussion in athletes: Evaluation and neuropsychological testing. Neurosurgery 47: 659–669.
Matser, E., Kessels, A., Lezak, M., Jordan, B., and Troost, J. (1999). Neuropsychological impairment in amateur soccer players. Journal of the American Medical Association 282: 971–973.
McCrea, M., Kelly, J. P., Kluge, J., Ackley, B., and Randolph, C. (1997). Standardized assessment of concussion in football players. Neurology 48: 586–588.
McCrea, M., Kelly, J. P., Randolf, C., Kluge, J., Bartolic, E., Finn, G., and Baxter, B. (1998). Standardized assessment of concussion: Onsite mental status evaluation of the athlete. Journal of Head Trauma Rehabilitation 13: 27–35.
McLatchie, G., Brooks, N., Galbraith, S., Hutchison, J. S. F., Wilson, L., Melville, I., and Teasdale, E. (1987). Clinical neurological examination, neuropsychology, electroencephalography and computed tomographic head scanning in active amateur boxers. Journal of Neurology, Neurosurgery, and Psychiatry 50: 96–99.
Meaney, D. F., Smith, D. H., Shreiber, D. I., Bain, A. C., Miller, R. T., Ross, D. T., and Gennarelli, T. A. (1995). Biomechanical analysis of experimental diffuse axonal injury. Journal of Neurotrauma 12(4): 689–694.
Murelius, O., and Haglund, Y. (1991). Does Swedish amateur boxing lead to chronic brain damage? A retrospective neuropsychological study. Acta Neurologica Scandanavia 83: 9–13.
Naunheim, R. S., Standeven, J., Richter, C., and Lewis, L. M. (2000). Comparison of impact data in hockey, football, and soccer. Journal of Trauma 48: 938–941.
Olesniewicz, M. H., Sallis, R. E., Jones, K., and Copp, N. (1997). The neuropsychological changes that occur from head concussions in football at the National Collegiate American Association Division Three level. Paper presented at the Sports Related Concussion and Nervous System Injuries Conference, Orlando, FL.
Peerless, S. J., and Rewastle, N. B. (1967). Shear injuries to the brain. The Canadian Medical Association Journal 96(10): 577–582.
Pfenninger, E. G., Reith, A., Breitig, D., Grunert, A., and Ahnefeld, F. W. (1989). Early changes of intracranial pressure, perfusion pressure, and blood flow after acute head injury. Journal of Neurosurgery 70: 774–779.
Pitts, L. (1991). The role of neuroimaging in minor head injury. Annals of Emergency Medicine 20(12): 1387, 1388.
Powell, J. (1999). Epidemiology of sports-related head injury. In Bailes, J. E., Lovell, M. R., and Maroon, J. C. (eds.), Sports-Related Concussion, Quality Medical Publishing, St. Louis, pp. 75–90.
Powell, J. W., and Barber-Foss, K. (1999). Traumatic brain injury in high school athletes. Journal of the American Medical Association 282: 958–963.
Prigatano, G. P. (1984). Neuropsychological rehabilitation after closed head injury in young adults. Journal of Neurology, Neurosurgery, and Psychiatry 47(5): 505–513.
Prigatano, G. P. (1999). Principles of Neuropsychological Rehabilitation., Oxford University Press, New York.
Prigatano, G. P., Glisky, E. L., and Konoff, P. S. (1996). Cognitive rehabilitation after traumatic brain injury. In Corrigan, P. W., Yudofsky, S., (eds.), Cognitive Rehabilitation for Neuropsychiatric Disorders, American Psychiatric Press, Washington, DC, pp. 223–242.
Putukian, M., and Echemendia, R. J. (1996). Managing successive minor head injuries: Which tests guide return to play? The Physician and Sports Medicine 24(11): 25–38.
Putukian, M., Echemendia, R. J., and Mackin, R. S. (2000). Acute effects of heading in soccer: A prospective neuropsychological evaluation. Clinical Journal of Sport Medicine 10: 104–109.
Quality Standards Subcommittee, American Academy of Neurology. (1997). Practice parameter: The management of concussion in sports (summary statement). Neurology 48: 581–585.
Raskin, S. A., and Mateer, C. A. (1999). Neuropsychological Management of Mild Traumatic Brain Injury, Oxford University Press, New York.
Reilly, T. R., and Thomas, V. (1976). A motion analysis of work-rate in different positional roles in professional football match play. Journal of Human Movement Studies 2: 87–97.
Roberts, A. H. (1969). Brain Damage in Boxers, Pitman Medical Scientific, London.
Ross, R. J., Cole, M., Thompson, J. S., and Kim, K. H. (1983). Boxers-computed tomography, EEG, and neurological evaluation. Journal of the American Medical Association 249: 211–213.
Saunders, R. L., and Harbaugh, R. E. (1984). The second impact in catastrophic contact-sports head trauma. Journal of the American Medical Association 252(4): 538, 539.
Schell, R. M., Kern, F. H., Greeley, W. J., Schulman, S. R., Frasco, P. E., Croughwell, N. D., Newman, M., and Reves, J. G. (1993). Cerebral blood flow and metabolism during cardiopulmonary bypass. Anesthesia and Analgesia 76(4): 849–865.
Schneider, P. G., and Lichte, H. (1975). Untersuchungen zur groesse der krafteinwirkung beim kopfballspiel des fussballers. Sportarzut un sprtmedizin 26: 10.
Shalmon, E., Bergensneider, M., Kelly, D., Caron, M., Iocolano, C., Hovda, D. A., Martin, N., Mazziotta, J., Phelps, J., and Becker. D. (1995). Existence of regional coupling between cerebral blood flow and glucose metabolism following brain injury [abstract]. Journal of Neurotrauma 12: 141.
Sironi, V. A., Scotti, G., Ravagnati, L., Franzini, A., and Marossero, F. (1982). CT scan and EEG findings in professional pugilists: Early detection of cerebral atrophy in young boxers. Journal of Neurosurgery 26: 165–168.
Stein, S. C., and Ross, S. E. (1990). The value of computed tomographic scans in patients with low-risk head injuries. Neurosurgery 26(4): 638–640.
Stiller, J. W., and Weinberger, D. R. (1985). Boxing and chronic brain damage. Psychiatric Clinics of North America 8(2): 339–356.
Stuss, D. T., Pogue, J., Buckle, L., and Bondar, J. (1994). Characterization of stability of performance of patients with traumatic brain injury: Variability and consistency on reaction time tests. Neuropsychology 8(3): 316–324.
Tegner, Y., and Lorentzon, R. (1991). Ice hockey injuries: Incidence, nature, and causes. British Journal of Sports Medicine 25(2): 87–89.
Tegner, Y., and Lorentzon, R. (1996). Concussion among Swedish elite ice hockey players. British Journal of Sports Medicine 30(3): 251–255.
Thomassen, A., Juul-Jensen, P., de Fine Olivarius, B., Braemer, J., and Christensen, A. L. (1979). Neurological, electroencephalographic, & neuropsychological examination of 53 former amateur boxers. Acta Neurologica Scandinavica 60(6): 352–362.
Torg, J. S., Vegso, J. J., Sennett, B., and Das, M. (1985). The National Football Head and Neck Injury Registry. 14 year report on cervical quadriplegia 1971-1984. Journal of the American Medical Association 254(24): 3439–3443.
Tysvaer, A., and Storli, O. (1981). Association football injuries to the brain: A preliminary report. British Journal of Sports Medicine 15(3): 163–166.
Tysvaer, A. T., and Storli, O. (1989). Soccer injuries to the brain. A neurologic and electroencephalographic study of active football players. American Journal of Sports Medicine 17(4): 573–578.
Tysvaer, A. T., Storli, O. V., and Bachen, N. I. (1989). Soccer in-juries to the brain. A neurologic and electroencephalographic study of former players. Acta Neurologica Scandinavica 80: 151–156.
Varney, N. R., and Roberts, R. J. (eds.). (1999). Evaluation and Treatment of Mild Traumatic Brain Injury, Erlbaum, Mahwah, NJ.
Yamakami, I., and McIntosh, T. K. (1991). Alterations in regional cerebral blood flow following traumatic brain injury in the rat. Journal of Cerebral Blood Flow Metabolism 11: 655–660.
Youngjohn, J. R., Burrows, L., and Erdal, K. (1995). Brain damage or compensation neurosis? The controversial post-concussion syndrome. The Clinical Neuropsychologist 9(2): 112–123.
Zariczny, B., Shattuck, L. J., Mast, T. A., Robertson, R. V., D'Elia, G. (1980). Sports related injuries in school age children. American Journal of Sports Medicine 8: 318–324.
Zemper, E. (1994). Analysis of cerebral concussion frequency with the most commonly used models of football helmets. Journal of Athletic Training 29: 44–50.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Echemendia, R.J., Julian, L.J. Mild Traumatic Brain Injury in Sports: Neuropsychology's Contribution to a Developing Field. Neuropsychol Rev 11, 69–88 (2001). https://doi.org/10.1023/A:1016651217141
Issue Date:
DOI: https://doi.org/10.1023/A:1016651217141