MARINA DEL REY, Calif. (AP) – Thanks to a revolution in the recognition of head injuries and the consequences they can hold for athletes at every level, concussion denial seems to be on the way out.

“It’s taken a long time to get there, but right now I think the public awareness is huge,” Dr. Robert Cantu of the Neurologic Sports Injury Center at Boston’s Brigham and Women’s hospital said Friday at the second National Sports Concussion Summit.

“It’s as if the Berlin Wall of concussion denial has fallen,” said sports agent Leigh Steinberg, noting a significant shift in both attitude and action within sports since the first summit was held a year ago.

Steinberg, who helped organize the summit along with the Sports Concussion Institute, is sponsoring a California program that will institute so-called “baseline testing” in 1,400 high schools, where athletes are given a cognitive exam that can be repeated after injuries to measure brain impairment. Other smaller states like Hawaii have introduced such testing, but the student athletes in California will represent the largest group ever to take the neurological exams, Steinberg said.

It’s an attempt to remedy the inherent difficulty in measuring the effects of head injuries.

“It’s a subjective diagnosis,” Steinberg said. “You don’t have a cast on your leg.”

Similar neurological tests were made mandatory last year in the NFL, which was represented at this year’s concussion summit after not appearing at the inaugural edition in 2007. NFL medical officials said the things they institute in the “laboratory” that is their playing field are likely to appear at lower levels of sport.

“As often happens in the NFL there is a trickle-down phenomenon,” said Dr. Elliott Pellman, the NFL’s medical director.

The NFL also made official last year what had long been an unwritten rule, that players who lose consciousness during a game or practice must not return to the field that day.

Other league changes include whistleblower provisions to confidentially report concussions and a booklet that will allow players and their families to identify symptoms.

“The commissioner is making a very strong statement that the safety of players takes precedence over competition,” Tucker said.

The optimism expressed by many of Friday’s medical speakers was guarded, and renewed awareness of the problem has at times only led doctors to learn more about its severity.

Steinberg said it’s gone from an “undiagnosed health epidemic” to an “under-diagnosed” health epidemic.

Studies have shown that in cases where athletes had three or more concussions, they were five times more at risk for early onset Alzheimer’s disease, three times more at risk of significant memory loss and four times more likely to have severely elevated depression.

Authorities noted that even the medical language can be insufficient. The formal name for a concussion is “mild traumatic brain injury,” or “MTBI.”

“I don’t know what’s so mild about mild traumatic brain injury,” said David Hovda, director of the UCLA Brain Injury Research Center.

Hovda said simply thinking hard can put someone who’s had a recent concussion in danger.

Steinberg put on two similar conferences in the 1990s before last year’s first concussion summit, an event that organizers now plan to hold annually.

Steinberg is famous for representing clients like Steve Young, whose career ended in a flurry of concussions. Steinberg described a moment in 1993 when he saw Troy Aikman after the Dallas Cowboys had beaten the San Francisco 49ers in the NFC title game.

“He asked me where he was,” Steinberg said. “He asked me if he’d played that day. He asked me if he’d won. I said, ‘Yes, you’re going to the Super Bowl.’ Ten minutes later he asked me where he was again.”

Steinberg said he knew at that point he had to work on maintaining the minds as well as the money of his clients and other athletes.

“It terrified me,” he said.

AP-ES-04-18-08 1947EDT