High School Football Brings Brain Trauma Dangers

About 40 percent of the injured players continued to play even though they had symptoms from the earlier head injury. Catastrophic head injuries resulted in 8 deaths, 46 permanent brain injuries and 36 serious injuries where the patient had a full recovery, the researchers found.

Boden believes high school football players should be discouraged from "leading with the head" -- using their heads to tackle. Of all the catastrophic head injuries, 81 percent resulted from helmet-to-helmet collisions and helmet-to-body collisions, he noted.

One expert agreed that players need to be more cautious.

"While the incidence of catastrophic head injuries in football appears to have decreased since the 1960s, they continue to occur and are particularly tragic," said Dr. James Linakis, a research associate at the Injury Prevention Center at Rhode Island Hospital and a pediatric emergency physician at Hasbro Children's Hospital in Providence.

But the study also leaves many unanswered questions, Linakis said. "Why is this type of injury so much more common in high school than in college players? Is there a developmental factor involved? Are high school athletes less emotionally mature and therefore less likely to report residual symptoms to the coaching staff? Are high school coaches and trainers less prepared to recognize signs and symptoms of potentially serious injury?" he wondered.

Linakis, who is also an associate professor of emergency medicine and pediatrics at Brown Medical School, agreed that "leading with the head" should be discouraged. "In addition, players who have received a concussion should be encouraged to report symptoms to the training staff and should be withheld from play until medically cleared," he said.

Many catastrophic head injuries resulted not from a major blow to the head but from multiple minor collisions, Linakis added. "Efforts to reduce this type of repetitive injury to the brain may also be important in reducing the incidence of catastrophic head injuries in high school football players," he said.

More information

For more information on head injury, visit the U.S. National Institute of Neurological Disorders and Stroke.

SOURCES: Barry P. Boden, M.D., physician, Orthopedic Center, Rockville, Md., and adjunct associate professor, Uniform Services University of the Health Sciences, Bethesda, Md.; James G. Linakis, M.D., Ph.D., research associate, Injury Prevention Center, Rhode Island Hospital, pediatric emergency physician, Hasbro Children's Hospital, associate professor of emergency medicine and pediatrics, Brown Medical School, Providence, R.I; July 2007,The American Journal of Sports Medicine