Concussion Grades: Guide to Understanding Concussion Severity

Concussion Grades: Guide to Understanding Concussion Severity

Learn the three concussion grades and their symptoms.

Concussion symptoms run the gamut from mild confusion to complete loss of consciousness and amnesia. Naturally, not all concussions can be viewed the same, because not all concussions are the same.

Concussion Grading

Surprisingly, there is no universally accepted chart or system for grading concussions. In fact, even the American Academy of Neurology (AAN) has moved away from its previous 1997 guidelines for grading concussions. Those earlier guidelines were based on the work done by the Colorado Medical Society in 1991, a standard which is still commonly referred to today by the medical community. We have summarized those standards below. (You can learn more about them here.)

Grade 1 Concussion

Classification: Mild
Symptoms: Less than 15 minutes
Loss of Consciousness: No
What to Do: In the event of a mild grade 1 concussion, remove the athlete from play. A trained professional should examine the athlete immediately and at five-minute intervals, looking for changes in mental status and post-concussive symptoms (both at rest and with exertion). If clear, the athlete may return to play within minutes.

Grade 2 Concussion

Classification: Moderate
Symptoms: More than 15 minutes
Loss of Consciousness: No
What to Do: In the event of a moderate grade 2 concussion, remove the athlete from play for the entire day. A trained professional should examine the athlete immediately and the following day. A neurologic examination should be performed by a physician. A return-to-play clearance should only be issued after one week of experiencing no symptoms both at rest and with exertion. In the event of multiple grade 2 concussions, return-to-play clearance may be extended to two weeks.

Grade 3a and 3b Concussion

Classification: Severe
Symptoms: More than 15 minutes
Loss of Consciousness: Brief (several seconds) – Grade 3a; Prolonged (several minutes) – Grade 3b
What to Do: The athlete should be immediately transported to the nearest emergency department via ambulance if consciousness does not return and/or there is a potential for severe injury (such as an immobilized cervical spine). A physician will immediately perform a neurologic evaluation and, in some cases, order neuroimaging tests. Hospital admission may sometimes be required. Players suffering from a grade 3a concussion may receive a return-to-play clearance as early as one week. Players who have had a grade 3b concussion may require two weeks before receiving a return-to-play clearance. Experiencing multiple grade 3 concussions will require an absence of at least one month from athletic activity.

Severe Concussion Symptoms

While a headache might be a perfectly normal concussion symptom that will resolve on its own, The Centers for Disease Control highlights a few severe concussion symptoms that require immediate medical attention. Regardless of any concussion grading system, these are the warning signs that should prompt you to seek immediate care!

Severe Concussion Symptoms In Children

  • Refuse to nurse or eat.
  • Won’t stop crying / inconsolable.
  • Have any of the following warning signs...

Severe Concussion Symptoms In Adults

  • Headache that worsens and doesn’t resolve
  • Loss of consciousness
  • Behavior that’s out of character
  • Becoming increasingly confused or agitated
  • Inability to recognize familiar people or places
  • Convulsions or seizures
  • Weakness, numbness, reduced coordination
  • Repeated vomiting or nausea
  • Slurred speech
  • Extreme drowsiness
  • Having one dilated pupil

Concussion recovery may be possible with a brain wellness support program. By focusing on cognitive stimulation, nutrition and hydration, physical fitness, and breathwork and vibration, some individuals have reported significant improvement.

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