Some athletes clear more quickly and can go back in to play.
Differences between the Colorado guidelines and the AAN parameters are clearest in the management of grade 2 and 3 concussions. The Colorado guidelines say an athlete should be sidelined for a month after a second grade 2 concussion or a first grade 3 concussion, but the new recommendations allow a return to play when the athlete has been asymptomatic for 2 weeks in either case. The 1997 recommendations in-clude a mental status test to rule out amnesia. The new practice options are designed primarily for football and ice hockey, in which concussion is common, but can be applied to almost any sport. They offer a systematic approach to prevent complications, such as second-impact syndrome and cumulative damage from multiple concussions, without needlessly limiting participation, says Jay H. Rosenberg, MD, who cowrote the article and is a staff neurologist at the Southern California Permanente Medical Group in San Diego.