Deaths from head trauma rare in young athletes
NEW YORK (Reuters Health) - Very few young athletes die from a blow to the head on the playing field, but such deaths that do occur could often have been prevented, a study published Monday suggests.
Looking at U.S. records of sudden deaths in athletes age 21 or younger, researchers found that between 1980 and 2009, an average of nine athletes died each year from blunt trauma.
That usually meant a blow to the head and neck, though some kids died from an impact to the chest or abdomen.
The majority of those who died were in high school, and football carried the biggest risk. Of 261 injury-related deaths in student athletes over 30 years, 57 percent happened in football, the researchers report in the journal Pediatrics.
In particular, the findings put a spotlight on so-called "second-impact syndrome," said senior researcher Dr. Barry J. Maron, of the Minneapolis Heart Institute Foundation.
That refers to cases where someone suffers a blow to the head while still recovering from a previous concussion. That second impact is more likely to have severe consequences, including bleeding inside the skull, brain swelling and death.
Among the 148 blunt-trauma deaths Maron's team found in football, there were 17 high school athletes who appeared to have died from second-impact syndrome.
Greater awareness of the danger of second-impact syndrome could help prevent such deaths, according to Maron.
"It wasn't that long ago that these concussions were thought to be fairly innocent," he told Reuters Health. "A lot of people may still think it's OK to 'get your bell rung,' then get back into the game."
Last year, the American Academy of Pediatrics (AAP) recommended that kids with concussions get cleared by a doctor before they can get back on the playing field.
But that also means coaches, parents and kids themselves need to know the signs of a concussion, so they'll be able to recognize the initial one.
Concussion symptoms include headache, dizziness, nausea, ringing in the ears, fatigue and confusion -- though these problems may not become noticeable until hours after the blow to the head.
Once a concussion is recognized, the AAP says that kids should rest, both physically and mentally. Schoolwork and other mental tasks, even video game playing, can make symptoms worse -- so athletes with a concussion may need a break from non-physical activities as well.
The message from the current findings is not that parents should be alarmed, according to Maron.
During the last five years of the study, there was one blunt-trauma death for every million high school and college athletes. By comparison, the rate of sudden death from heart problems -- also considered a rare event among young athletes -- was eight per million.
"The number of deaths and the risk (of death) are low," he said. "So there's some reassurance there."
But awareness of the risk of death from head trauma could help make these tragic events even rarer, according to Maron's team. Besides keeping kids with concussions off the playing field, improvements in protective equipment or changes in playing rules might help, the researchers say.
Since blunt-trauma deaths are so rare in young athletes, it's hard to tell whether the risk has changed over time, Maron noted.
But in this study, the average numbers held steady: nine deaths per year over the entire 30-year period, and nine per year between 2000 and 2009.
Another recent study found that the overall rate of concussion among U.S. high school athletes may actually be climbing.
In 2008, the study found, there were five concussions for every 10,000 times high schoolers hit the playing field. That was up from roughly one per 10,000 in 1997. Again, football led the way in injuries, followed by soccer, lacrosse and basketball.
The researchers said the reasons for the increase were not certain, but better recognition of concussion symptoms was likely one reason. The fact that kids are getting bigger, stronger and faster could be another.
