Boden BP, Tacchetti RL, Cantu RC, et al. Catastrophic head injuries in high school and college football players. Am J Sports Med. 2007;35(7):1075-1081.
The authors aimed to update the profile of catastrophic head injuries in high school and college football players as well as to determine risk factors. Ninety-four incidents of severe head injuries reported to the National Center for Catastrophic Sports Injury Research were reviewed. The reports were made during 13 academic years (September 1989 to June 2002).
The study period indicated an average of 7.23 (standard deviation = 2.05) direct high school and college catastrophic head injuries in scholastic football participants per year.
The injuries resulted in subdural hematoma in 75 athletes, subdural hematoma with diffuse brain edema in 10 athletes, diffuse brain edema in 5 athletes, and arteriovenous malformation or aneurysm in 4 athletes. Fifty-nine percent of the contacts reported that the athlete had a history of a previous head injury, of which 71% occurred within the same season as the catastrophic event.
The study indicated that the incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. The reason is unknown, but a higher percentage of high school players were noted to have played with residual symptoms from a prior head injury. Coaches, athletes, trainers, and clinicians must be aware that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.