Current issues in managing sports-related concussion.

THE ISSUE OF DETERMINING THE readiness of athletes to return to action following a head injury has received recognition as a major public health issue. Concern over the health of the athlete with a concussion has prompted the development of parameters to guide management and returnto-play issues. These guidelines, however, have been controversial within the sports medicine community. The controversy appears to result from a lack of scientific foundation, and thus an arbitrary delineation of concussion grades and return-to-play criteria. This article critically examines concussion management guidelines and makes recommendations for the development of practical strategies. Two actual concussion cases illustrate these issues.