KO more likely with top-of-head concussions

The location of impact generally doesn’t affect concussion outcomes, but top-of-the-head impacts more often result in loss of consciousness, a new study reports.

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When researchers analyzed data on player-to-player collisions among high school football players from the National High School Sports-Related Injury Surveillance Study (2008-2009 through 2012-2013), they found that most of the 2526 concussions they included in the analysis resulted from impacts on the front of the head (44.7%) and side of the head (22.3%). Back-of-the-head and top-of-the-head impacts accounted for 5.7% and 5.5% of concussions, respectively. In the remaining 21.8%, or 551 concussions, the location of impact was unknown.

Impact location didn’t affect the number of symptoms, type of symptoms, symptom resolution time, or length of time before returning to play, but players who suffered a top-of-the-head impact were more likely to lose consciousness-8% compared with 3.5% for other impact locations.

Because top-of-the-head impacts occurred more often when players had their head down, the researchers support preventive measures, including enforcing rules that limit initiating contact with the head, consistent use of properly fitted protective equipment, and educating young athletes in the head-up tackling technique.

The findings suggest that impact location probably isn’t useful for predicting clinical outcomes or managing concussion, the researchers note. A history of concussion may be more clinically useful because in this study, as in previous ones, recurring concussion was associated with more symptoms, longer delays in returning to play, and longer time to resolution of symptoms. 

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