Preparticipation assessment for head injury

Objective: To determine the evidence base for recommendations regarding the pre-participation screening for head injury. Data Sources: The relevant literature was searched through the use of Medline (1966 to 2004), Google and Sport Discus (1975 to 2004) searches, hand searches of journals and reference lists and discussions with experts and sporting organisations worldwide. Data Synthesis/Methods: Consensus recommendations are summarized. No formal statistical analysis is presented Results: Although pre-participation examinations are widely performed, there are no evidence-based guidelines to direct physicians as to the minimum requirements for the baseline assessment of head injury. Conclusions: Expert consensus would suggest that a baseline neuropsychological examination, preferably using a computerised test battery, should be performed in order to guide return to play following subsequent concussive injuries. In addition, there are important medicolegal considerations in regard to the value of a documented assessment both at the start and end of an athlete's career with any team.