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Excerpt
The goal of this project was to develop and test a new clinically useful grading system, return to play guidelines and an on field exam for concussion. Review of existing literature on grading systems and neuropsychological testing was undertaken. Based on the data, the McGill grading system, return to play guidelines and McGill on field exam were developed. Subjects were male university athletes from McGill football and hockey varsity teams. On pre season exam, each athlete underwent the new field exam baseline test. During the sport's season, all concussions were serially evaluated with the on field exam and graded with the McGill grading system, Cantu, Colorado and AAN guidelines. Athletes with ongoing symptoms were further evaluated using new imaging techniques. One salient difference between the new guidelines and those previously published is the subdivision of grade I into A, B and C. The McGill on field exam, grading system and return to play guidelines accurately correlate with clinical presentation, course and neuroimaging findings. The McGill grading systems and return to play guidelines, in combination with the McGill on field exam and new neuroimaging, are potentially useful in predicting clinical presentation and course of concussion in athletes. Effects on long-term sequelae are still undetermined and will be evaluated in our prospective study.
