Summary and conclusionsOf 1900 head injuries serious enough to be admitted to the neurosurgical unit in Glasgow over a five year period, 52 (2-7%) were due to "sport." Golf, horse-riding, and Association football were the sports most commonly linked with serious head injury. Golfing injuries were all compound depressed fractures, and all these patients made a good recovery; horse-riding produced more severe injuries, three of the eight patients being left with residual disability. Much attention has been directed to preventing repeated minor head injury in boxing, but this study emphasises the need for preventing both the primary head injury and secondary complications associated with other sports.

SUMMARY Twenty active amateur boxers were studied seeking evidence of neurological dysfunction and, if present, the best method for detecting it. Seven of these boxers had an abnormal clinical neurological examination, eight an abnormal EEG and nine of 15 examined had abnormal neuropsychometry. The CT scan was abnormal in only one. An abnormal clinical examination correlated significantly (p < 005) with an increasing number of fights, and an abnormal EEG with decreasing age (p < 0O05). In several of the neuropsychometric tests, the boxers were significantly worse than controls (p < O O5). Neuropsychometry was the best method for detecting neurological dysfunction.Boxing remains controversial. In its recent report, the British Medical Association (BMA) collected evidence showing that, in both professional and amateur boxers, there is clinical, radiological and neuropsychological evidence of permanent brain damage.'In some the damage is severe.

The cause, management and outcome of 23 patients with a pancreatic fistula following acute pancreatitis are reviewed. Nineteen patients developed an external fistula following necrosectomy or drainage of a pancreatic abscess or pseudocyst; four of these patients died. In the 15 survivors spontaneous closure occurred in 11 cases with low output fistulae; operative intervention was needed in the four cases with high output fistulae. Four patients with internal fistulae had not undergone previous surgery; two of them had a pancreaticopleural fistula with associated pancreaticogastric fistulae, while two had pancreatic ascites. All four of these patients required surgical intervention and one died.

Most ocular injuries involve only the external eye. However, in approximately one-third of cases the intraocular structures are damaged with potentially sight threatening consequences. A small number of sports, such as soccer, rugby, hockey and the racquet sports are responsible for most injuries. Sport is responsible for between 25-40% of all eye injuries severe enough to require hospital admission. Most of these are recognised as being largely preventable and methods of reducing the number and severity of such injuries are of prime importance.

The origins of karate and its evolution as a sport are described. Karate injuries tend to occur in three main areas: the head and neck, the viscera, and the limbs. Effective legislation controlling karate, which could help prevent injuries, is lacking at the moment and should be established. Recommendations for the prevention of injury include the introduction of weight classes, mandatory provision of protective equipment such as padded flooring, and the outlawing of certain uncontrollable methods of attack.