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July 6, 2007 -- Catastrophic football head injuries are rare, but they may be more than three times as common in high school football players than college athletes, a new study shows.
Catastrophic head injuries, which include bleeding or swelling in the brain, can be fatal.
Even if football head injuries aren't severe, players with head injuries should stay out of the game, note the researchers, who included Barry Boden, MD, of The Orthopedic Centre in Rockville, Md.
"Coaches, athletes, parents, athletic trainers, and all medical personnel need to be educated to never allow an athlete to continue playing football with ongoing neurologic symptoms," write Boden and colleagues.
Coaches also "need too continue educating players to avoid hitting with the head," the researchers write in July's edition of The American Journal of Sports Medicine.
Boden's team reviewed 94 cases of severe head injuries sustained by high school football players and college football players between 1989 and 2002.
All but two of those cases occurred in high school athletes.
The cases, which were reported to the National Center for Catastrophic Sports Injury Research, included eight players who died from their head injuries and 46 athletes who suffered permanent paralysis, memory loss, seizures, or other permanent injuries.
The head injuries typically happened when the athlete's head hit another player's head, other body part, or the ground during a tackle. Head injuries were more common during games than during practices.
Based on the number of high school and college football players -- including the vast majority who don't get severe head injuries -- the researchers estimate that catastrophic head injuries are 3.28 times more common in high school football players than in college players.
The study doesn't show why that is, but Boden's team has several theories.
High school football players may more vulnerable than college players to severe head injuries because their brains are younger. Or perhaps high school players are more likely to have poorly fitting or substandard helmets, note the researchers.
The study includes details on 59 of the 92 catastrophic head injury cases.
Of those 59 cases, 35 players had a previous head injury, typically sustained earlier in the same season but not on the same day as their catastrophic head injury.
The researchers also learned that out of 54 cases, more than a third occurred in players who still had symptoms of previous head injuries.
That practice of playing hurt has got to stop, the researchers note.
"Football is a very macho sport," Boden says in a news release from the American Orthopaedic Society for Sports Medicine. "These injured athletes are allowed to return to play before full recovery, leaving them susceptible to a more significant injury."