MTBI is caused by the inertial effect of a mechanical impact to the head with sudden rotational acceleration forces. mTBI produces, in the less severe cases, only transient disturbances of ionic homeostasis with temporary disturbances of brain function. Depending on the severity of the trauma, animal and human studies have demonstrated focal intra-axonal alterations in neurofilamentous/cytoskeletal network and impairment of axoplasmatic transport, which may lead to progressive axonal swelling, detachment or even cell death over a period of hours or days, the so-called process of delayed axotomy. Disturbances of ionic homeostasis, acute metabolic changes and cerebral blood flow alterations compromise the ability of neurons to function and render brain cells vulnerable. These processes may predispose brain cells to a vulnerable state for an unknown period; therefore we recommend that any confused player with or without amnesia should be taken off the ice and not be permitted to play again for at least 24 hours.