Reflections on 40 years as a sideline physician

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In this study the author presents his personal observations concerning football injuries in a historical perspective with additional literature citations.


Aspects of brachial plexus and cervical spine injuries, neurapraxia, face mask infractions, concussion, acute subdural hematoma (SDH), and the so-called second-impact syndrome are addressed.


The list of conclusions presented in this paper is as follows: there is more than one kind of brachial plexus injury; wedging of cervical vertebrae may be normal; neurapraxia presents a problem for return to play; face mask injuries are rarely serious; definitions of concussion vary; acute SDH requires immediate transfer to a hospital; and the second-impact syndrome may be a myth to some.

Abbreviations used in this paper:SDH = subdural hematoma; VB = vertebral body.

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Article Information

Address reprint requests to: G. Robert Nugent, M.D., Department of Neurosurgery, The Robert C. Byrd Health Sciences Center of West Virginia University, Morgantown, West Virginia 26506. email:

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