Concussion in sport: best from Berlin, direction from Dublin and gems from gridiron

Sports-related concussion (SRC) is one of the most important medical issues in contact and collision sports around the world. The NFL Head, Neck and Spine Committee’s Concussion Diagnosis and Management Protocols, published in this edition of the BJSM , represent a comprehensive approach to concussion management in professional sport.1 The protocols highlight how much the approach to SRC has evolved, particularly since the first International Conference on Concussion in Sport held in Vienna in November 2001.2 This evolution has been driven largely by concerns (both medical and public) regarding potential short-term and long-term adverse outcomes following SRC, and have been underpinned by evolving concepts from five international consensus meetings, and an explosion of research on SRC over the past decade. The fifth International Conference on Concussion in Sport was held in Berlin in October 2016. The meeting involved more than 18 months of active planning, 10 scientific committee members, 23 additional expert panellists and 420 participants representing 24 countries.3 The output included 12 comprehensive systematic reviews (which collectively screened nearly 60 000 articles), 202 additional conference scientific abstracts, a consensus paper4 and revised standardised concussion recognition and assessment tools (SCAT5, ChildSCAT5 and CRT5). The output from the Berlin meeting provides a blueprint of 11 key principles of concussion management (the 11 ‘R’s’).4 Translation and implementation of these principles …