Head Blows and Intelligence

Two or more significant blows to the head while playing sports can harm teenagers' thinking abilities for years to come, according to studies that suggest such injuries are more serious than some coaches and parents might think.

One of the studies, all published in today's Journal of the American Medical Association, explored how often concussions occurred in football, wrestling, soccer, basketball, softball, baseball, field hockey and volleyball at 235 high schools nationwide from 1995-96 through 1997-98.

There were 1,219 concussions--63 percent of them in football--and 99 students suffered two or more, said researchers led by John W. Powell, a professor of kinesiology and an athletic trainer at Michigan State University. The researchers estimated that more than 62,800 concussions occur annually among high school students nationwide in the sports they studied.

Michael W. Collins, a neuropsychologist at Henry Ford Health System in Detroit, and colleagues, meanwhile, studied 393 college football players and found that about one in three had suffered a concussion and one in five had suffered two or more.

Those who had suffered two or more were significantly more likely to report continuing problems with headaches, sleep and concentration, and they scored significantly worse on tests of the ability to learn words, to think quickly and to handle complex tasks. A complex task in the real world would be cooking a big Thanksgiving dinner, for example.

Players who had learning disorders--13.5 percent of the sample--fared even worse if they had two or more concussions, suggesting that the disorders make the brain especially vulnerable to jarring injuries. About 12 percent of all collegians have learning disorders, research has shown.

A third article reported that amateur soccer players scored lower on tests of memory and planning than other amateur athletes did, and that repeated blows to the head may be the culprit.

Children's Ear Infections

Taking out a child's tonsils and adenoids does little to combat ear infections, even though that is the reason such surgeries are often performed, according to a new study.

"Given that we found both operations to have limited efficacy and in view of their not inconsiderable risks, morbidity and costs, we believe that neither operation ordinarily should be considered as an initial intervention" in children with chronic middle-ear infections, the report from Children's Hospital in Pittsburgh said. "Instead we believe that nonsurgical management should be attempted first, with tube placement to be considered later."

After that, adenoid removal should be considered in cases where middle-ear infections continue despite the use of ear tubes, it said.

The study, reported in today's Journal of the American Medical Association, was based on a look at 461 children ages 3 to 15. Some underwent surgery to remove adenoids and some to remove both adenoids and tonsils. Others had no surgery.

The report concluded that surgery offered only modest help against otitis media--the middle-ear inflammation that affects one in every six children in the first year of life and often remains common through childhood.