Summary / conclusions The SCAT is the most widely accepted and deployable sport concussion assessment and screening tool currently available .
There is some degree of support for using the SCAT2/SCAT3 and ChildSCAT3 in the evaluation of SRC , with and without baseline data .
The addition of an oculomotor examination seems indicated , although the most valid method for assessing oculomotor function is not clear .
Video-observable signs of concussion show promise , but there is insufficient evidence to warrant widespread use at this time
Objectives Several iterations of the Sport Concussion Assessment Tool ( SCAT ) have been published over the past 16 years .
Our goal was to systematic ally review the literature related to the SCAT and provide recommendations for improving the tool .
Eye Tracking Detects Disconjugate Eye Movements Associated with Structural Traumatic Brain Injury and Concussion
Abstract Disconjugate eye movements have been associated with traumatic brain injury since ancient times . Ocular motility dysfunction may be present in up to 90 % of patients with concussion or blast injury . We developed an algorithm for eye tracking in which the Cartesian coordinates of the right and left pupils are tracked over 200 sec and compared to each other as a subject watches a short film clip moving inside an aperture on a computer screen . We prospect ively eye tracked 64 normal healthy noninjured control subjects and compared findings to 75 trauma subjects with either a positive head computed tomography ( CT ) scan ( n=13 ) , negative head CT ( n=39 ) , or nonhead injury ( n=23 ) to determine whether eye tracking would reveal the disconjugate gaze associated with both structural brain injury and concussion . Tracking metrics were then correlated to the clinical concussion measure Sport Concussion Assessment Tool 3 ( SCAT3 ) in trauma patients . Five out of five measures of horizontal disconjugacy were increased in positive and negative head CT patients relative to noninjured control subjects . Only one of five vertical disconjugacy measures was significantly increased in brain-injured patients relative to controls . Linear regression analysis of all 75 trauma patients demonstrated that three metrics for horizontal disconjugacy negatively correlated with SCAT3 symptom severity score and positively correlated with total St and ardized Assessment of Concussion score . Abnormal eye-tracking metrics improved over time toward baseline in brain-injured subjects observed in follow-up . Eye tracking may help quantify the severity of ocular motility disruption associated with concussion and structural brain injury
Summary / conclusions The SCAT is the most widely accepted and deployable sport concussion assessment and screening tool currently available .
There is some degree of support for using the SCAT2/SCAT3 and ChildSCAT3 in the evaluation of SRC , with and without baseline data .
The addition of an oculomotor examination seems indicated , although the most valid method for assessing oculomotor function is not clear .
Video-observable signs of concussion show promise , but there is insufficient evidence to warrant widespread use at this time
Objectives Several iterations of the Sport Concussion Assessment Tool ( SCAT ) have been published over the past 16 years .
Our goal was to systematic ally review the literature related to the SCAT and provide recommendations for improving the tool .