Mild traumatic brain injury (TBI) is estimated to affect 55.9 million people each year, with 4.6 million mild TBIs sustained in the United States of America (US) and Canada.[8]Dewan MC, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018 Apr 27;130(4):1080-97.
http://www.ncbi.nlm.nih.gov/pubmed/29701556?tool=bestpractice.com
Mild TBI, which represents approximately 90% of all TBIs, increasingly affects aging populations who experience falls, and increasing incidence may also reflect rising numbers of road traffic collisions in low- and middle-income countries and widespread concerns regarding long-term effects of sports-related concussion.[9]Woodrow RE, Winzeck S, Luppi AI, et al. Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury. Brain. 2023 Aug 1;146(8):3484-99.
https://academic.oup.com/brain/article/146/8/3484/7051141
http://www.ncbi.nlm.nih.gov/pubmed/36811945?tool=bestpractice.com
[10]Maas AIR, Menon DK, Adelson PD, et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017 Dec;16(12):987-1048.
Between 1.1 and 1.9 million sports-and recreation-related concussions occur annually in the US children ages ≤18 years, with a subset of approximately 400, 000 sports-related concussions in high school athletes.[11]Bryan MA, Rowhani-Rahbar A, Comstock RD, et al. Sports- and recreation-related concussions in US youth. Pediatrics. 2016 Jul;138(1):e20154635.
http://www.ncbi.nlm.nih.gov/pubmed/27325635?tool=bestpractice.com
[12]Herring S, Kibler WB, Putukian M, et al. Selected issues in sport-related concussion (SRC|mild traumatic brain injury) for the team physician: a consensus statement. Br J Sports Med. 2021 Nov;55(22):1251-61.
https://bjsm.bmj.com/content/55/22/1251
http://www.ncbi.nlm.nih.gov/pubmed/34134974?tool=bestpractice.com
Between 2% and 15% of athletes of all ages participating in organized sports will suffer a concussion during one season.[3]Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 2019 Feb;53(4):213-25.
https://bjsm.bmj.com/content/53/4/213.long
http://www.ncbi.nlm.nih.gov/pubmed/30705232?tool=bestpractice.com
Concussions continue to be a problem in American football despite the increased awareness and changes to rules and equipment. Annual football concussion rates, including recreational, high school, collegiate, and professional levels, indicate that players have an annual concussion incidence estimated to be 4% to 20%.[13]Bailes JE, Cantu RC. Head injury in athletes. Neurosurgery. 2001 Jan;48(1):26-45; discussion 45-46.
http://www.ncbi.nlm.nih.gov/pubmed/11152359?tool=bestpractice.com
[14]DePadilla L, Miller GF, Jones SE, et al. Self-reported concussions from playing a aport or being physically active among high school students - United States, 2017. MMWR Morb Mortal Wkly Rep. 2018 Jun 22;67(24):682-85.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013088
http://www.ncbi.nlm.nih.gov/pubmed/29927909?tool=bestpractice.com
Collegiate and high school American football players who sustain an initial concussion are three times more likely to sustain a second concussion in the same season.[15]Guskiewicz KM, Weaver NL, Padua DA, et al. Epidemiology of concussion in collegiate and high school football players. Am J Sports Med. 2000 Sep-Oct;28(5):643-50.
http://www.ncbi.nlm.nih.gov/pubmed/11032218?tool=bestpractice.com
One study found that 70.4% of American football players reported having experienced symptoms of a concussion during the previous year; only 23.4% of concussed football players realized they had suffered a concussion.[16]Delaney JS, Lacroix VJ, Leclerc S, et al. Concussions among university football and soccer players. Clin J Sport Med. 2002 Nov;12(6):331-8.
http://www.ncbi.nlm.nih.gov/pubmed/12466687?tool=bestpractice.com
Concussion incidence rates appear to be significantly higher in females than in males for a number of team sports, including soccer, ice hockey, and basketball.[17]Cheng J, Ammerman B, Santiago K, et al. Sex-based differences in the incidence of sports-related concussion: systematic review and meta-analysis. Sports Health. 2019 Nov/Dec;11(6):486-91.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822209
http://www.ncbi.nlm.nih.gov/pubmed/31567052?tool=bestpractice.com
[18]Prien A, Grafe A, Rössler R, et al. Epidemiology of head injuries focusing on concussions in team contact sports: a systematic review. Sports Med. 2018 Apr;48(4):953-69.
http://www.ncbi.nlm.nih.gov/pubmed/29349651?tool=bestpractice.com
[19]Bretzin AC, Covassin T, Wiebe DJ, et al. Association of sex with adolescent soccer concussion incidence and characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e218191.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779117
http://www.ncbi.nlm.nih.gov/pubmed/33904911?tool=bestpractice.com
Women typically report more complex symptomatology and slower recovery in both sports-related and non-sports-related concussion.[2]Maas AIR, Menon DK, Manley GT, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022 Nov;21(11):1004-60.
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00309-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36183712?tool=bestpractice.com
[20]Farace E, Alves WM. Do women fare worse? a metaanalysis of gender differences in outcome after traumatic brain injury. Neurosurg Focus. 2000;8(1):e6.
http://www.ncbi.nlm.nih.gov/pubmed/16924776?tool=bestpractice.com
[21]Colvin AC, Mullen J, Lovell MR, et al. The role of concussion history and gender in recovery from soccer-related concussion. Am J Sports Med. 2009 Sep;37(9):1699-704.
http://www.ncbi.nlm.nih.gov/pubmed/19460813?tool=bestpractice.com
[22]Bazarian JJ, Blyth B, Mookerjee S, et al. Sex differences in outcome after mild traumatic brain injury. J Neurotrauma. 2010 Mar;27(3):527-39.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867588
http://www.ncbi.nlm.nih.gov/pubmed/19938945?tool=bestpractice.com