When "having your bell rung" really means "mild TBI": Terminology matters in sport-related brain injury

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Concussion, mild traumatic brain injury, and mild head injury are diagnostic terms that have traditionally been interchangeable. Clinicians argue that each diagnosis carries a distinct set of features (especially between mTBI and concussion), but in the meantime, the exact terminology describing impact to the head can lead to stereotyping and inaccurate expectation of symptoms and recovery. In a recent study that reflected a university athlete's familiarity and understanding of terms, athletes thought that:

  • The term "concussion" was the most familiar term, carried the least negative expectations, and was an injury that led to temporary, minor symptoms.
  • The term "mild TBI" was the least familiar term, carried the most negative expectations, and was an injury that led to more serious, permanent symptoms-including depression and memory loss.
  • The term "mild head injury" was considered the injury most related to contact sports, and was the only term associated with bleeding.

This imbalance of understanding and expectation not only reflected a lack of education on the part of the athletes, but also reflected a preference for terminology use on the field. For instance, using the term "concussion" instead of "brain injury" in order to keep spirits and recovery expectations high can discourage complete understanding of the injury, and potentially encourage ill-advised actions such as prematurely sending an athlete back to sport.

Weber M & Edwards MG. The effect of brain injury terminology on university athletes' expected outcome from injury, familiarity and actual symptom report. Brain Injury. (September 2010).