E-Pearl of the Week: How Long Must an Athlete Wait Before Returning to Play After a Concussion?

September 27, 2011


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Brought to you by the Resident and Fellow Section of Neurology®.

September 26, 2011

How long must an athlete wait before returning to play after a concussion?

It is essential that patients have both physical and cognitive rest until their concussive symptoms have fully resolved. If a second concussion occurs before fully recovering from the first, there is a risk of developing "second-impact syndrome," which is characterized by diffuse brain swelling and carries an estimated 50% risk of mortality. Graded exertion can be instituted once the athlete is no longer symptomatic. Assuming symptoms do not recur with exertion the athlete can progress back to full play.


  1. Zafonte R. Diagnosis and management of sports-related concussion: a 15-year-old athlete with a concussion. JAMA 2011;306:79-86.
  2. Sports-related recurrent brain injuries--United States. MMWR Morb Mortal Wkly Rep. 1997;46:224-227.

Submitted by:
Amy Gelfand, MD. Dr. Gelfand is a member of the editorial team for the Neurology Resident & Fellow Section.

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