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Lester Mayers, MD

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In reply

I thank Dr Casson et al and Professor Edwards for their interest and appreciate their comments about my recent article,¹ providing me with the opportunity to restate my position, hopefully with added clarity. Casson et al disagree with my conclusion advocating a postconcussion RTP interval of at least 4 weeks, stating that it "is flawed owing to a misinterpretation and misapplication of basic research results to the clinical sphere."

They add that I have "erroneously equated the clinical term alteration of mental status . . . with the broader nonspecific term cerebral dysfunction." In fact, my minireview concluded that clinical symptoms and signs clear before resolution of other measures of cerebral dysfunction. Certainly, the different studies I referenced demonstrating what their authors and I believe represent persisting cerebral dysfunction for up to 30 days after concussion did not measure altered mental status because mental status and standard . . . [Full Text of this Article]

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