Traumatic brain injury in high school athletes

Context The potential seriousness of mild traumatic brain injury (MTBI) is increasingly recognized; however, information on the frequency of MTBI amon g high school athletes is limited. Objective To identify the type, frequency, and severity of MTBI in selected high school sports activities. Design Observational cohort study.. Setting and Participants Two hundred forty-six certified athletic trainers recorded injury and exposure data for high school varsity athletes particip ating in boys' football, wrestling, baseball and field hockey, girls' volle yball and softball, boys' and girls' basketball, and boys' and girls' socce r at 235 US high schools during 1 or more of the 1995-1997 academic years. Main Outcome Measures Rates of reported MTBI, defined as a head-injured pla yer who was removed from participation and evaluated by an athletic trainer or physician prior to returning to participation. National incidence figur es for MTBI also were estimated. Results Of 23 566 reported injuries in the 10 sports during the 3-year stud y period, 1219 (5.5 %) were MTBIs. Of the MTBIs, football accounted for 773 (63.4%) of cases; wrestling, 128 (10.5%); girls' soccer, 76 (6.2%); boys' soccer, 69 (5.7%); girls' basketball, 63 (5.2%); boys' basketball, 51 (4.2% ); softball, 25 (2.1%); baseball, 15 (1.2%); field hockey, 13 (1.1%); and v olleyball, 6 (0.5%). The injury rates per 100 player-seasons were 3.66 for football, 1.58 for wrestling, 1.14 for girls' soccer, 1.04 for girls' baske tball, 0.92 for boys' soccer, 0.75 for boys' basketball, 0.46 for softball, 0.46 for field hockey, 0.23 for baseball, and 0.14 for volleyball. The med ian time lost from participation for all MTBIs was 3 days. There were 6 cas es of subdural hematoma and intracranial injury reported in football. Based on these data, an estimated 62 816 cases of MTBI occur annually among high school varsity athletes participating in these sports, with football accou nting for about 63 % of cases. Conclusions Rates of MTBI vary among sports and none of the 10 popular high school sports we studied is without the occurrence of an MTBI. Continued i nvolvement of high school sports sponsors, researchers, medical professiona ls, coaches, and sports participants is essential to help minimize the risk of MTBI.