Brain Lesions in Players of Contact Sports

Source: Autti T, et al. Brain lesions in players of contact sports. Lancet 1997;349:1144.

News of sports-associated neurologic abnormalities seem to abound lately. This short report describes MRI abnormalities found in 15 soccer players, ages 18-34, and 17 male American football players. Many had required orthopedic repairs, and eight had undergone traumatic unconsciousness. All had played in "elite" professional game schedules for 1-15 years. Twenty aged-matched non-athletic men served as controls.

Eleven soccer players, seven football players, and five controls showed high cerebral white matter signal changes, ranging in small groups from medians of 39 to four in number. Seventy-nine percent of these lesions were regarded as axonal rarefaction of no serious import, but eight soccer players, three football players, and two controls showed 1-9 lesions compatible with ischemia. The authors observe that the football players consistently wore helmets while the soccer players did not. The authors suggest that the non-wearing of helmets contributed to the higher incidence of ischemic "clots" in soccer players and imply that they should wear helmets, too.

With this conclusion, I agree. Past articles in Neurology Alert have pointed out the protective effects of having bicyclists wear helmets and urging automobile drivers to wear seatbelts. There are those of us who occasionally watch soccer games and wonder with each one who will be the next player to get a self-induced subdural hematoma. —fp