Computerized neurocognitive testing in the medical evaluation of sports concussion.

In some individuals, return to normal function after a concussion occurs quickly and is easy to assess. In these individuals, neuropsychological testing is not necessary and adds little additional information to the clinical exam. In more difficult circumstances, such as a timely return to a contact or collision sport, or prolonged severe symptoms, additional information may be helpful to the clinician. In these circumstances, the addition of computerized neurocognitive testing offers practical advantages for detection of subtle or profound cognitive impairment, especially if compared with a valid baseline. However, as with any tool, there are also important limitations to its proper use and interpretation. Since there are insufficient neuropsychologists to provide regular monitoring of every concussion, pediatricians need to be aware of the utility, advantages and limitations of computerized neurocognitive testing. It is but one additional component of the management armamentarium that can aid their clinical management of the evolution and resolution of their patient’s impairment from concussion. The medical evaluation of concussion involves a comprehensive assessment of brain function, including the vestibulo-ocular system, balance, mood, and cognitive function. Traditional clinical exam techniques to evaluate cognitive function are limited. Sideline assessment tools such as the Sport Concussion Assessment Tool 2 (SCAT2) have been designed for sideline evaluation of concussion but have limitations beyond the acute concussion period. The development of in-office computerComputerized Neurocognitive Testing in the Medical Evaluation of Sports Concussion