Clinical Edge

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Head Impacts Linked with Varying CNS Symptoms

Neurology; ePub 2017 Feb 1; Stewart, Kim, et al

Intentional (ie, heading) and unintentional head impacts are each independently associated with moderate to very severe central nervous system (CNS) symptoms, a recent study found. Amateur soccer players completed baseline and serial online 2-week recall questionnaires (HeadCount) and reported (1) soccer practice and games, (2) heading and unintentional soccer head trauma, and (3) frequency and severity (mild to very severe) of CNS symptoms. A total of 222 soccer players (79% male) completed 470 HeadCount questionnaires. Mean (median) heading/2 weeks was 44 (18) for men and 27 (9.5) for women. Researchers found:

  • 1 or more unintentional head impacts were reported by 37% of men and 43% of women.
  • Heading-related symptoms were reported in 20% (93 out of 470) of the HeadCounts.
  • Heading in the highest quartile was significantly associated with CNS symptoms when controlling for unintentional exposure.
  • Those with 2+ unintentional exposures were at increased risk for CNS symptoms as were those with a single exposure when controlling for heading.


Stewart WF, Kim N, Ifrah CS, et al. Symptoms from repeated intentional and unintentional head impact in soccer players. [Published online ahead of print February 1, 2017]. Neurology. doi:10.1212/WNL.0000000000003657.