Torg Grading System

In 1991 Joe Torg, who is much better known for his cervical spine axial load compression injuries causing quadriplegia, proposed a six-tiered grading system for concussion. This system was published in the textbook titled Athletic Injuries to the Head, Face and Neck.

It should be noted that head injuries were only partly discussed and very major part of the book did indeed deal with the cervical spine and neck injuries. As it relates to concussion, his grading system has chiefly focused on short-term confusion and presence of amnesia at the time of injury or shortly after the incidence. He also introduced the “bell rung” term, referring to possible noise sensitivity following mild traumatic brain injury. It is important to note, that duration of transient loss of consciousness was also considered as important feature in this classification system.

Grade 1 “Bell rung”; short-term confusion; unsteady gait; dazed appearance; no amnesia

Grade 2 Posttraumatic amnesia only; vertigo; no loss of consciousness

Grade 3 Posttraumatic retrograde amnesia; vertigo; no loss of consciousness

Grade 4 Immediate transient loss of consciousness

Grade 5 Paralytic coma; cardiorespiratory arrest

Grade 6 Death ¹⁾.