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Making the diagnosis and determining the severity of a head injury immediately on\u2010pitch or off\u2010field is a major challenge for team physicians, especially because clinical signs of a brain injury can develop over several minutes, hours, or even days after the injury. A standardized approach is useful to support team physicians in their decision whether the player should be allowed to continue to play or should be removed from play after head injury. A systematic, football\u2010specific procedure for examination and management during the first 72\u00a0hours after head injuries and a graduated Return\u2010to\u2010Football program for high\u2010level players have been developed by an international group of experts based on current national and international guidelines for the management of acute head injuries. The procedure includes seven stages from the initial on\u2010pitch examination to the graduated Return\u2010to\u2010Football program. Details of the assessments and the consequences of different outcomes are described for each stage. Criteria for emergency management (red flags), removal from play (orange flags), and referral to specialists for further diagnosis and treatment (persistent orange flags) are provided. The guidelines for return to sport after concussion\u2010type head injury are specified for football. Thus, the present paper presents a comprehensive procedure for team physicians after a head injury in high\u2010level football.<\/jats:p>","DOI":"10.1111\/sms.13750","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T06:59:42Z","timestamp":1592463582000},"page":"1846-1858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Recommendations for initial examination, differential diagnosis, and management of concussion and other head injuries in high\u2010level football"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-0601","authenticated-orcid":false,"given":"Nina","family":"Feddermann\u2010Demont","sequence":"first","affiliation":[{"name":"University Hospital and University of Zurich Zurich Switzerland"},{"name":"Swiss Concussion Center Schulthess Clinic Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Chiampas","sequence":"additional","affiliation":[{"name":"US Soccer Federation Chicago IL USA"},{"name":"Departments of Emergency and Orthopedics Feinberg School of Medicine Northwestern University Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte M.","family":"Cowie","sequence":"additional","affiliation":[{"name":"The Football Association St George's Park Staffordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3425-4546","authenticated-orcid":false,"given":"Tim","family":"Meyer","sequence":"additional","affiliation":[{"name":"Institute of Sports and Preventive Medicine Saarland University Saarbruecken Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3534-456X","authenticated-orcid":false,"given":"Anna","family":"Nordstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University Ume\u00e5 Sweden"},{"name":"School of Sport Sciences UiT The Arctic University of Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1478-8068","authenticated-orcid":false,"given":"Margot","family":"Putukian","sequence":"additional","affiliation":[{"name":"University Health Services Princeton University Princeton NJ USA"},{"name":"Rutgers\u2010Robert Wood Johnson Medical School New Brunswick NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5349-7650","authenticated-orcid":false,"given":"Dominik","family":"Straumann","sequence":"additional","affiliation":[{"name":"University Hospital and University of Zurich Zurich Switzerland"},{"name":"Swiss Concussion Center Schulthess Clinic Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efraim","family":"Kramer","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509332497"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-017-0854-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515599634"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092205"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2013.865269"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0000000000000227"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.04.011"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517728264"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63954-7.00008-2"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100338"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097878"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00002-2"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000128"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2017.01.021"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2016.10.005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03581.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2018.09.009"},{"key":"e_1_2_6_19_1","unstructured":"Excellence NIfHaC.Head Injury: Assessment and Early Management.2014.https:\/\/www.nice.org.uk\/guidance\/cg176\/resources\/head\u2010injury\u2010assessment\u2010and\u2010early\u2010management\u2010pdf\u201035109755595493. 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