Acute and long-term management of sports-related closed head injuries.

Aggressive participation in athletics is rewarded in many ways in our society. As long as there is such strong impetus for participation in athletics, the risks of head injuries for participants will remain. Important strides made in understanding of the pathophysiology of head injuries may lead to improved treatment strategies in the future. In light of the current lack of effective therapies, however, the best options remain injury prevention, early and appropriate recognition, and limitation of subsequent, further injury. Frequently the medical staff is encouraged to allow the athlete to return to play based on the desires of the coach, team, fans, parents, and even the athlete himself. A thorough understanding of the potentially serious risks of repetitive injury, however, mandates that only a proper conservative period of observation and evaluation will best serve the competitor.