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Head & Neck Injury Basics

1. What is a catastrophic head or neck injury?

A catastrophic head injury would be any injury sustained to the head by direct impact and classified either as traumatic brain injury (i.e., skull fracture) or mild traumatic brain injury (i.e., subdural hematoma). A catastrophic cervical spinal cord injury is one in which a structural distortion of the cervical spinal column has occurred and is associated with actual or potential damage to the spinal cord.

According to the National Center for Catastrophic Sports Injury Research direct catastrophic head or neck injuries resulting from participation in the skills of a sport are divided into 3 categories:
  1. fatal (the injury causes the death of the athlete),
  2. nonfatal (the injury causes a permanent neurologic functional disability), and
  3. serious (a severe injury, but the athlete has no permanent functional disability, for example, a fractured cervical vertebra that does not cause paralysis).
2. In which sports are athletes susceptible to catastrophic head or neck injuries?

The incidence of catastrophic cervical spine injuries in sports and activities is low compared to other injuries, yet when these injuries occur they are troubling due to serious health conditions that could develop and the potential for permanent loss of neural function (i.e.; quadrapalegia).

The sport that is associated with the highest number of direct catastrophic head and neck injuries is American football. This is due to the nature of the sport, but also due to the high numbers of participants in the sport. Sports such as cheerleading, gymnastics, lacrosse, and ice hockey have a higher incidence of direct catastrophic head and neck injuries, due in part to their lower number or participants.

3. What are some of the common symptoms associated with catastrophic head or neck injuries?

Any loss of consciousness, or even an altered state of consciousness (i.e., dizzy, foggy, fatigued), obvious deformity of the head or neck, direct pain, and numbness, tingling, or burning sensations on both sides of the body (i.e., both arms, both legs) are common symptoms of a possible catastrophic head or neck injury.

So you suspect you have or someone else has sustained a catastrophic head or neck injury. Now what?

If you suspect a catastrophic head or neck injury they should NOT be moved. Activate EMS and stabilize the head and neck so it does not move until a trained emergency medical responder (i.e., physician, athletic trainer, EMT) takes over. Even if you suspect they might just have a head injury still treat it as if they also might have a neck injury. Often these occur together so these situations should be treated the same. Until a trained emergency medical responder arrives, take note of the injured person's level of consciousness, breathing, and heart beat.

4. What could happen if a catastrophic head or neck injury is left untreated or is inappropriately treated and you or your athlete continues to participate?

Unfortunately, if someone suffering a catastrophic head or neck injury is left untreated, or worse, treated inappropriately they could die or end up paralyzed. These individuals need immediate medical care and should never be allowed to return to participation.

  1. Mueller FO,Cantu RC: National Center for Catastrophic Sport Injury Research: Twenty Ninth Annual Report Fall 1982—Spring 2011. 2011, University of North Carolina: Chapel Hill.
  2. Casa DJ, Guskiewicz KM, Anderson SA, et al.: National athletic trainers' association position statement: preventing sudden death in sports. J Athl Train. 2012;47:96-118.