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Handb Clin Neurol. 2018;158:25-37. doi: 10.1016/B978-0-444-63954-7.00004-5.

Catastrophic neurologic injuries in sport.

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Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Dr. Robert C. Cantu Concussion Center, Emerson Hospital, Concord, MA, United States.
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address:


Tens of millions of children and adults participate in organized sport in the United States each year. Although uncommon, fatal and severe nonfatal brain and spine injuries can occur during these activities. These "catastrophic" injuries have been noted in contact sports such as football, rugby, and ice hockey, as well as in noncontact sports including baseball, cheerleading, swimming and diving, equestrian, gymnastics, pole vault, rodeo, snow skiing, snowboarding, and wrestling. They happen at all levels of play, from youth to professional. Among all sports, football has the highest number of fatal brain and cervical spine injuries. While these injuries are more frequent in high school football, the rate is higher amongst college football athletes. Patterns exist in the types of brain and spine injuries most often occurring as a result of traumatic impacts in sport, but incidence and mechanisms of injury vary dramatically between sports. Understanding these patterns is essential to informing prevention efforts; football, pole vault, and cheer are all examples of sports benefiting from successful catastrophic injury prevention efforts. Participating in sport provides many benefits to physical and mental health. Despite these benefits, rare devastating injuries can be traumatic for the athletes, their families, and communities and can raise safety concerns that may reduce participation in sport. Understanding and preventing these types of injuries are critical to fostering participation in sport and ensuring both children and adults reap the physical, social, and mental benefits of sport.


brain; catastrophic; cheer; contact sports; fatalities; football; injury; pediatric; pole vault; spinal cord injury; spine; sport; traumatic brain injury

[Indexed for MEDLINE]

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