Objective-To evaluate the frequency of concussion in Swedish ice hocke
y and to establish a uniform grading and treatment model for concussio
ns of different severity. Methods-Frequency of concussion was investig
ated in two studies, one retrospective and one prospective. In the ret
rospective study, all Swedish elite ice hockey players (n=265) were as
ked to answer a questionnaire on the number and treatment of previous
concussions. Only concussions diagnosed by a doctor were recorded. The
questionnaire was completed by 227 players (86%). In the prospective
study, all injuries including concussions occurring during game and pr
actice in the Swedish Elite League (n=12 teams) were recorded during f
our years. The causes of injury, referees judgements, diagnosis, treat
ment, and time absent from ice hockey were registered on special cards
. Results-In the retrospective study, 51 out of 227 players (22%) in t
he Swedish Elite League reported at least one concussion. In the prosp
ective study, 52 concussions were reported. The incidence of a concuss
ion is at least one concussion every year/team or a yearly risk of abo
ut 5% for a player to sustain a concussion. Most concussions occurred
during league play (81%). Body contact (checking or boarding) was the
most common cause of concussions. The players were absent from full tr
aining and play on a mean of 6 d. Conclusions-As this injury is potent
ially dangerous it must be treated seriously according to a simple tre
atment model presented. In cases of repeated concussions during the sa
me season, a longer period of time away from play is suggested. In pla
yers who have sustained several concussions over the years a thorough
medical examination including EEG, CT/MRI, MRI, and neuropsychological
tests should be performed. If any of these is pathological the player
should be advised to give up ice hockey.