High School Football Riskier for Head Injury Than College

Possibly due to athletes who continue to play despite previous head injury

WEDNESDAY, July 11 (HealthDay News) -- Catastrophic head injuries, although relatively rare, are more likely to occur in high school football players than college football players, possibly because more high school players continue to play after previous head injuries, according to a study in the July issue of the American Journal of Sports Medicine.

Barry P. Boden, M.D., from the Orthopaedic Center in Rockville, Md., and colleagues reviewed the characteristics of 94 cases of severe football head injuries in high school and college football players reported to the National Center for Catastrophic Sports Injury Research from 1989-2002.

The researchers found that there were more injuries among high school football players than college football players (0.67 versus 0.21 per 100,000). Most injuries were subdural hematomas (75 athletes), followed by subdural hematoma with diffuse brain edema, diffuse brain edema, and arteriovenous malformation or aneurysm. The athletes had a history of head injury in 59 percent of cases, and 39 percent of these continued playing with residual neurologic symptoms. The injuries led to death in 9 percent of cases, permanent neurologic injuries in 51 percent of cases, and serious injuries with full recovery in 40 percent of cases.

"The incidence of catastrophic head injuries in football has remained low since the advent of the modern-day football helmet in the early 1970s," Boden and colleagues conclude. "The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury."

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