Thirty-seven former football players of the Norwegian national team underwent a neurological and electroencephalographic (EEG) examination to investigate the incidence of head injuries due to heading the ball. Sixteen players complained of protracted and permanent symptoms commonly attributed to the post-concussional syndrome: headache, irritability, dizziness, lack of concentration and impaired memory. A significantly increased incidence of EEG abnormalities was found in players compared with matched controls. The high incidence of EEG changes is probably the result of a cumulative effect due to repeated head traumas.

Head injuries have been shown to account for between 4 and 22% of soccer injuries. Clinical and neuropsychological investigations of patients with minor head trauma have revealed organic brain damage. 69 active football (soccer) players and 37 former players of the Norwegian national team were included in a neurological and electroencephalographic (EEG) study to investigate the incidence of head injuries mainly caused by heading the ball. 3% of the active and 30% of the former players complained of permanent problems such as headache, dizziness, irritability, impaired memory and neck pain. 35% of the active and 32% of former players had from slightly abnormal to abnormal EEG compared with 13 and 11% of matched controls, respectively. There were fewer definitely abnormal EEG changes among typical 'headers' (10%) than among 'nonheaders' (27%). The former players were also subjected to cerebral computed tomography (CT), a neuropsychological examination and a radiological examination of the cervical spine. One-third of the players were found to have central cerebral atrophy and 81% to have from mild to severe (mostly mild to moderate) neuropsychological impairment. The radiological examination of the cervical spine revealed a significantly higher incidence and degree of degenerative changes than in a matched control group.

In 1975 the authors sent a questionnaire to all players in the Norwegian First Division League Clubs to record the incidence of head injuries due to heading. The conclusion of the questionnaire is that there seems to be a low percentage of serious head injuries. None of the players had been operated on for epi-or subdural hematoma or other brain damage and only a few have had concussion due to heading. In sixty per cent of the players a full neurological examination and EEG recording was undertaken. The result of these studies will be published in a subsequent article.

Forty-three former players for the National Football Team of Norway were examined clinically and radiologically for degenerative changes in the cervical spine. Compared with men of the same age groups the onset of degeneration was 10-20 years earlier and the frequency of degeneration was significantly higher. Degenerative changes were not especially high in "headers", but this group had a higher frequency of subjective complaints and clinical findings such as reduced cervical movements.

Thirty-seven former soccer players of the National Football Team of Norway were individually examined with an extensive battery of psychologic tests. The neuropsychologic examination demonstrated mild to severe deficits regarding attention, concentration, memory, and judgment in 81% of the players. This may indicate some degree of permanent organic brain damage, probably the cumulative result of repeated traumas from heading the ball.