ABSTRACT
Although concussion was first recognized as a separate entity from severe traumatic brain injury over 1000 years ago, we still lack a unified consensus definition and evidence-based management protocols. The role of concussion guidelines has evolved over the past century, driven largely by both political and scientific agendas, from a neurosurgical era of trying to rule out severe TBI in concussed athletes to the modern approach of trying to diagnose the minimal significant injury and then to provide strategies to manage this by using best practice. Numerous sporting groups and medical professional bodies have put forward their own guidelines with varying degrees of scientific rigor. This chapter presents a historical perspective regarding how concussion was originally understood and how it has evolved into our modern clinical understanding. The future challenge will be to unify the various groups and bodies in a single global initiative and then to utilize objective investigational platforms to validate these guidelines.
