First-Ever Pediatric Concussion Guidelines: Real-Life Cases

Debra Houry, MD, MPH


November 15, 2018

Editorial Collaboration

Medscape &

Case 4: Does a Hard Hit Always Lead to a Concussion?

Figure 4. Points of impact. Courtesy of the Matthew Gfeller Sport-Related TBI Research Center, University of North Carolina at Chapel Hill.

The helmet impact sensors of a 17-year-old football defensive end recorded 31 head impacts over two practice sessions. During the morning practice, two impacts were sustained to the front of the head, registering gravitational forces (g) of 79 g and 98 g, respectively. These accelerations exceed crash test dummy head accelerations following an airbag deployment, but they do not factor in the potential systemic polytrauma sustained by individuals in a motor vehicle crash. During the second practice session later that same day, he sustained two more head impacts to the front of the head. These measured 65 g and 64 g, respectively.

The athlete reported symptoms to the athletic training staff only after the last impact and did not complain of any symptoms from the impacts sustained earlier in the day.