Regardless of location, concussions serious: study

By Andrew M. Seaman NEW YORK (Reuters Health) - Concussions in high school football players are equally serious no matter where on the head the hit occurred, according to a new study. Regardless of where on the head the players were hit, their symptoms were similar, as were the length of time symptoms lasted and how long players stayed off the field, researchers found. “We were actually a little bit surprised,” Dawn Comstock told Reuters Health. “Based on some of our prior research, we expected to see some differences.” Comstock is the study’s lead author from the Colorado School of Public Health and the University of Colorado at Denver. She and her colleagues write in the journal Pediatrics that few studies have examined concussion outcomes based on where on the head the impact occurred. About five to six concussions occur among high school football players per 10,000 games or practices, they add. There has been increasing concern over any knocks to the head that high school athletes may experience, because of how common those hits are and the lingering problems they’re associated with (see Reuters Health stories of May 7, 2014 here: and of May 14, 2014 here: “We wanted a more complete understanding of concussion in high school football,” Comstock said. In particular, her team wondered whether knowing how the concussion was received could help doctors diagnose and manage athletes more effectively. Using data from the National High School Sports-Related Injury Surveillance Study, from the 2008-2009 and 2012-2013 seasons, they were able to analyze 2,526 football-related concussions that occurred during games and practices. About 45 percent of concussions were caused by hits to the front of the head. The second most common hit to cause concussions was to the side of the head, followed by back of the head and finally the top of the head. After reviewing the data, the researchers found that where on the head the impact occurred made no difference in terms of the symptoms the players had, the length of time the symptoms persisted and how long players had to be kept off the field. “We can’t predict which athletes are more likely to have more severe symptoms or worse outcomes based only on how their injuries occur,” Comstock said. “Every clinician needs to take every concussion very seriously.” The researchers did find that players who received a concussion to the top of their head were more likely to lose consciousness, compared to those who received an impact to other parts of their head. The vast majority of players who received impacts to the top of their head had their heads down at the time of the hit, compared to less than a quarter of those hit in other parts of their head. “What we can say is that these findings definitely support the call to take the head out of the game if you will,” Comstock said. She added that the findings support the tackling technique that keeps players’ heads up, compared to their heads being aimed down while running at another player. “We don’t ever want our work to be used to frighten and pull kids out of sports, but this work is a kind of reminder that the coaches, parents, physicians and everyone involved need to work together to make those sports safe to play,” Comstock said. SOURCE: Pediatrics, online August 11, 2014.