Concussion in the adolescent athlete is a common sports and recreation injury. Traditional management of concussion in this age group has focused on sport return-to-play decisions. However, new research on mild traumatic brain injury has dramatically changed the management of concussion. During the acute healing phase, physical and cognitive rest are crucial for healing. In the school-aged athlete, new concepts, such as complete brain rest, have made school management decisions as important as sport return-to-play decisions. Despite tremendous improvements in the understanding of concussion, most of the research has been done in young adults. The lack of prospective studies in early adolescent student athletes limits definitive management recommendations. This article reviews the current understanding of the epidemiology, pathophysiology, and clinical presentation of concussion and discusses the unique factors involved in clinical management of concussion in the adolescent student-athlete.
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