Pathophysiology of Sports-Related Concussion: An Update on Basic Science and Translational Research

CONTEXT: Concussions that occur during participation in athletic events affect millions of individuals each year. Although our understanding of the pathophysiology of concussion has grown considerably in recent years, much remains to be elucidated. This article reviews basic science and relevant translational clinical research regarding several aspects of concussion. EVIDENCE ACQUISITION: A literature search was conducted using PubMed from 1966 to 2010, with an emphasis on work published within the past 10 years. Additional articles were identified from the bibliography of recent reviews. RESULTS: Basic science and clinical data both indicate that there is a period of increased vulnerability to repeated injury following a concussion and that its duration is variable. Growing evidence indicates that postinjury activity is likely to affect recovery from brain injury. Data suggest that long-term sequelae may result from prior concussion—particularly, repeated injuries. The unique aspects of cerebral development may account for differences in the effects of concussion in children and adolescents when compared with adults. CONCLUSIONS: The available pathophysiologic data from basic science and clinical studies have increased the evidence base for concussion management strategies—the approaches to which may differ between young athletes and adults.