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The most difficult concussion sign to achieve agreement on was blank or vacant stare, which had weak (κ value 0.4 0.59) agreement for both naïve and expert raters.
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Guskiewicz, whose three sons played Pop Warner football, said that it is often difficult to diagnose concussions in younger players because the injuries are invisible and the player must describe how he feels.
Wales full-back Leigh Halfpenny says his three-month absence with concussion was "difficult" and "unpredictable" to deal with.
The problem: Detecting a concussion is difficult, and unknowingly allowing athletes to play with one can cause a lifetime of brain damage.
The problem is, concussion is notoriously difficult to diagnose with immediacy – in large part due to the wide variety of symptoms which may or may not be present.
However, because of the current debate surrounding the diagnostic criteria for concussion, it is difficult to determine if injuries presenting to various health care settings are truly dissimilar, or if these differences result from varying diagnostic criteria used by physicians practicing in different clinical settings.
Return to play decisions for pediatric athletes following a concussion can be difficult.
As no two patients are alike, the variability in signs and symptoms resulting from impacts to the body and head that produce concussive symptoms make it difficult to say who truly has a concussion after the initial impact.
And concussions are very difficult to diagnose, says neurosurgeon Jam Ghajar, a clinical professor of neurosurgery at Stanford and founder and director of its Concussion and Brain Performance Center.
Teammates said that Savage seemed fine and coherent, but concussions can be difficult to assess because symptoms can develop later.
The finding, published in the journal Pediatrics, is believed to be the first to focus on one of the most difficult social challenges of treating concussions: a pervasive sports culture that encourages young athletes to keep playing through pain.
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