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Analysis and Evolution of Head Injury in Football

Levy, Michael L. M.D., Ph.D.; Ozgur, Burak M. M.D.; Berry, Cherisse B.S.; Aryan, Henry E. M.D.; Apuzzo, Michael L.J. M.D.

doi: 10.1227/01.NEU.0000134598.06114.89
Literature Reviews

OBJECTIVE: To review head injury in football through historical, anatomic, and physiological analysis.

METHODS: We obtained data from a thorough review of the literature.

RESULTS: The reported incidence of concussion among high school football players dropped from 19% in 1983 to 4% in 1999. During the 1997 Canadian Football League season, players with a previous loss of consciousness in football were 6.15 times more likely to experience a concussion than players without a previous loss of consciousness (P < 0.05). Players with a previous concussion in football were 5.10 times more likely to experience a concussion than players without a previous concussion (P = 0.0001). With the implementation of National Operating Committee on Standards for Athletic Equipment standards, fatalities decreased by 74% and serious head injuries decreased from 4.25 per 100,000 to 0.68 per 100,000.

CONCLUSION: Significant declines in both the incidence and severity of head injury have been observed. The enhanced safety records in football can be attributed to the application of more stringent tackling regulations as well as the evolving football helmet. The role of a neurosurgeon is critical in further head injury prevention and guidelines in sport.

Division of Neurosurgery, University of California at San Diego School of Medicine, San Diego, California

Division of Neurosurgery, University of California at San Diego School of Medicine, San Diego, California

Keck School of Medicine, University of Southern California, Los Angeles, California

Division of Neurosurgery, University of California at San Diego School of Medicine, San Diego, California

Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

Reprint requests: Michael L. Levy, M.D., Ph.D., Suite 502, 8010 Frost Street, San Diego, CA 92123. Email: mlevy@chsd.org

Received, June 9, 2003.

Accepted, February 23, 2004.

Copyright © by the Congress of Neurological Surgeons