What happens when an athlete suffers a concussion outside of sport? An in-depth analysis of non-sport-related concussion in adolescent athletes.

INTRODUCTION: Sport-related concussion (SRC) has been widely studied in high school athletes, yet non-sport-related concussion (non-SRC) has received less attention. Thus, in a cohort of high school athletes diagnosed with non-SRC, we sought to: 1) describe demographic characteristics, medical history, and recovery patterns, and 2) compare injury severity and recovery outcomes across common non-SRC mechanisms. METHODS: The current retrospective cohort study included athletes aged 14-18 years who sustained non-SRCs and presented to a regional concussion center between 11/2017-04/2022. Concussions were classified as non-SRCs if sustained outside sport. Injury mechanisms included motor vehicle collisions (MVCs), person-to-object impacts, falls, recreational motor vehicle incidents, assaults, and other causes. Primary outcomes were initial symptom severity (Post-Concussion Symptom Scale; PCSS), time to return-to-learn (RTL), symptom resolution (SR), and return-to-play (RTP). RESULTS: Of 110 athletes, 63.6% were female and mean age was 16.1 years (SD = 1.2). MVCs, object impacts, and falls were most common. Median PCSS was highest in the 'other' and person-to-object groups. Falls showed the shortest RTL and SR, while MVCs and assaults showed longer recovery. SR was shorter among athletes evaluated by an athletic trainer (p = 0.040). CONCLUSION: Non-SRCs show heterogeneous recovery patterns. Findings support applying graduated RTP frameworks to non-SRC management.