Head injuries in skiers and snowboarders in British Columbia

Background: At the Vancouver General Hospital Neurosurgical Service there h ave been a significant number of seriously brain injured snowboarders, seem ingly out of proportion to the number of skiers. The purpose of this study was to determine whether snowboarders suffered more serious head injuries t han skiers in the Vancouver catchment area. Methods: The British Columbia T rauma Registry was searched for patients incurring head injuries while skii ng or snowboarding on British Columbia mountains during the period from Jan uary 1992 to December 1997. Patients were included if they were admitted to hospital and underwent neurosurgical consultation. Results: A total of 40 skiers and 14 snowboarders met the above criteria. Of the skiers, 15% susta ined a severe head injury by Glasgow Coma Score, another 30% sustaining mod erate head injuries, while 29% of snowboarders had a severe injury and 36% a moderate injury. A concussion was present in 60% of the skiers and 21% of the snowboarders. Snowboarders suffered an intracranial hemorrhage in 71% of the cases compared to 28% of the skiers. A craniotomy was performed acut ely in 10% of skiers and in 29% of snowboarders, Three deaths occurred as a direct result of head injury, one while snowboarding. All but one of the s urviving skiers were able to return home, whereas four of 13 surviving snow boarders required additional inpatient rehabilitation or transfer to anothe r acute hospital for ongoing care. Conclusions: Snowboarders suffer more si gnificant head injuries compared to skiers in this series and are much more likely than skiers to require an intracranial procedure. In our opinion, t his indicates that additional safety measures, in particular the use of man datory helmets, should be considered by ski areas and their patrons.