Just came across this:
http://www.nytimes.com/2009/03/26/fa...helmet.html?em
"Head injuries: Looking for signs and acting quickly
By Liz Robbins
Published: March 26, 2009
The 18-year-old runner was rounding third base for home so fast that his batting helmet flew off. The infielder rifled the ball to the catcher, but it caught the runner instead, hitting his suddenly bare head. He scored, walked to the dugout, and five minutes later began to experience a violent headache.
He had an epidural hematoma — the same bleeding in the brain that the 45-year-old actress Natasha Richardson fatally suffered last week after her innocent fall on a beginner ski slope in Quebec. And the circumstances seemed equally one in a million. But the young baseball player lived through his injury because the field was close to a hospital and he was taken there right away, and because Dr. Robert Cantu was able to operate quickly.
"This kind of blood clot we're dealing with here almost never happens in helmeted sports — unless the helmet comes off," said Dr. Cantu, a director of the Neurological Sports Injury Center at Brigham and Women's Hospital in Boston.
Ms. Richardson was not wearing a helmet when she fell and she suffered what the New York medical examiner described last week as a "blunt trauma to the head." She was initially lucid, the ski resort said, and declined treatment. Not until nearly four hours after the accident did her condition quickly deteriorate and Ms. Richardson was rushed to a local hospital hours outside Montreal. She died March 18 at Lenox Hill Hospital in Manhattan.
With the public shock surrounding Ms. Richardson's sudden death subsiding, the medical community, as well as parents and leaders of recreational, youth and college sports are taking harder looks at the inherent risks, and seeking lessons.
Traumatic brain injury — a blow to the head that disrupts the normal function of the brain — occurs yearly in recreational and organized sports in the United States at a rate of about 207,830 a year, according to a 2007 study by the Centers for Disease Control and Prevention. The C.D.C. said the exact number of fatalities is unknown but Dr. Cantu said deaths represent less than 1 percent of total injuries. The agency said children in sports are more likely than adults to have head injuries.
"Helmets, although they do not prevent concussion, have a virtually 100 percent record of preventing skull fractures," Dr. Cantu said. "Had she been wearing a helmet," he said of Ms. Richardson, "she would have been alive."
The type of fatal injury Ms. Richardson suffered is almost always caused by a fracture of the temporal bone, paper-thin compared to the rest of the skull, which in turn can cause an artery tear that sets up the possibility of rapid bleeding, Dr. Cantu said. While the medical examiner would not confirm a fracture, it is consistent with that kind of resulting hemorrhage.
Last season, 43 percent of skiers and snowboarders wore helmets, according to the National Ski Areas Association, up from 25 percent in 2002. Seventy percent of children 9 or younger wore helmets. There was an equally important lesson from the Richardson tragedy. "Never, ever, after a head injury," Dr. Cantu said, "should you not get checked out if the symptoms get worse."
The C.D.C. provides program tool kits, "Heads Up," for high school coaches to identify symptoms of concussions, including dizziness, confusion and slow response. The slogan? "It's better to miss one game than the season."
Michael Cott of Roslyn, N.Y., missed six months of club soccer after his second concussion in one week at a summer camp in 2003. An opponent, trying to head the ball, slammed Michael's forehead instead, knocking him unconscious.
Michael returned to play only after his father, Noel Cott, mandated that he wear padded headgear, made by Full 90; Michael was teased, but he and his father became converts to the cause.
Football and basketball lead the number of brain-injury-related emergency room visits, joining the recreational sports of skiing, bicycling, driving all-terrain vehicles, and playground activities, the C.D.C. reported.
In collegiate sports, a new study shows a higher incidence of concussions for women than men, led by women's ice hockey, said Dr. Margot Putukian, director of athletic medicine at Princeton University. Identifying a concussion, and soon, is key.
"It's so difficult when you have a mild injury, you might get fooled," Dr. Putukian said. "It is not always the body-to-body contact, but often concussions are quite subtle."
Darcy Strain wishes he could have seen the signs when his son, Ethan, 11, was fiercely checked from behind by a much larger 12-year-old in an ice hockey tournament in Chicago in January.
Ethan told his father he felt dizzy and had a headache after the game but felt well enough to play the next day. Mr. Strain, who lives in Houston and grew up in Manitoba playing on frozen ponds without a helmet, thought Ethan was fine.
But days later, neurological tests showed that Ethan had a concussion. He suffered debilitating headaches and loss of short-term memory and has been unable to attend school in eight weeks.
Mr. Strain bought Ethan a top-of-the-line helmet to wear after he is cleared to play again. And he urges friends to monitor their children's injuries. "It brings it all close to home when that actress passed away with a little bump on the head from falling on a ski slope," Mr. Strain said, his voice quavering in a phone interview. "There's a reason why a little bump got her — everything went wrong that could have gone wrong. You don't realize it could happen, until it happens to you.""