Risks and management of concussion in contact sports: SCAT5 and World Rugby guidelines

Abstract

Introduction: Concussion (CC) was addressed as a current problem in sport, especially in rugby, where repeated impacts and limited head protection increased the risk of injury. It was argued that CTE mainly corresponded to a functional alteration of the central nervous system, with diverse clinical manifestations and, on occasions, delayed onset, which favoured underdiagnosis and non-compliance with care guidelines. Development: The organisation of the nervous system and the bony protection of the brain were described, along with relevant anatomical aspects (cerebral cortex, functional areas and vascularisation). Traumatic brain injury was defined as a sudden exchange of mechanical energy, and injuries were classified as primary and secondary, with diffuse and focal forms. It was explained that, in CC, acceleration, deceleration, and rotation forces triggered neurochemical and neurometabolic events that produced neurological dysfunction. It was noted that symptoms could arise hours or days later, and that loss of consciousness was observed in a minority of cases. Clinical evaluation using standardised tools such as SCAT5, applied off the field and by trained personnel, was emphasised. Protocols for immediate removal, assessment of warning signs, and gradual return to play, with stepwise progression and medical supervision, were detailed. Conclusion: It was concluded that prevention and timely management, based on World Rugby protocols and guidelines, reduced complications such as further concussions, second impact syndrome, and neurocognitive sequelae, preserving the health and quality of life of the athlete.