We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Convolutions of the Silent Sports Concussion: A Neuropsychologist’s Response to the Dark Ages of Rule-Based Return-to-Play Decisions

Ann B. Shuttleworth-Edwards, PhD
Arch Neurol. 2009;66(3):416-421. doi:10.1001/archneurol.2009.9.
Text Size: A A A
Published online


The recent minireview by Dr Mayers1 lends compelling support to similar concerns expressed in the September 2008 edition of Archives of Clinical Neuropsychology.2 At issue in both of these articles1,2 is the hazard of ignoring the possibility that there may be clinically “silent” consequences of a sports concussion with associated return-to-play (RTP) risks. Dr Mayers recommends an extended 4- to 6-week postconcussion RTP interval in place of the commonly used 1- to 2-week interval as an imperative protective measure against this risk. However, it is hardly necessary to point out that such a blanket 4- to 6-week rule may cause some athletes to be kept out of sports longer than necessary, while at the same time there can be no guarantee that every athlete will be recovered after 4 to 6 weeks. In this respect, Dr Mayers actually states that few of the researchers he cites assessed their athletes for periods longer than 1 month and consequently “the total duration of the measured abnormal responses remains unknown.”1 Therefore, Dr Mayers' so-called management revision is unlikely to survive as a viable solution, being merely a sideways move within the discredited rule-based framework of management and not in line with the forward modern move toward fine individualized assessment of the concussed athlete.3,4

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
PubMed Articles