BackgroundThere is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports.MethodsWe conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database was searched for brain injury cases among 5–19 year-olds playing ice hockey, soccer, American football (football), basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as “struck by player,” “struck by object,” “struck by sport implement,” “struck surface,” and “other.” A descriptive analysis was performed.ResultsThere were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP). Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%), followed by soccer (19.0%) and football (12.9%). In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post) among younger players. In baseball, a common mechanism in the 5–9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females).InterpretationMany sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.

Aim To report on visual acuity (VA) and angiographic outcomes in patients presenting with subfoveal choroidal neovascular membranes (CNV) secondary to punctate inner choroidopathy (PIC), treated with photodynamic therapy (PDT) with verteporfin combined with systemic corticosteroids. Methods A prospective case series of patients with subfoveal CNV secondary to PIC was analysed. All patients were treated with PDT combined with oral prednisolone (1 mg/kg body weight/day) which was started 5 days before PDT. Fluorescein angiography was performed at baseline and every 3 months post-treatment to establish the size, position, and activity of the CNV. Visual acuity was measured using the ETDRS scale. Further PDT treatment was carried out at follow-up visits if there was angiographic evidence of ongoing CNV activity. Results Five female patients with a mean age of 30.4 years (range 25-43 years) were treated over a 12-month period. The mean greatest linear diameter (GLD) of the CNV was 1.66 mm (range 0.46-3.28 mm). A mean improvement in vision of nine ETDRS letters (range À15-20 letters) after treatment was found, which was maintained at final followup. The mean follow-up time was 12 months (range 10-14 months). The mean number of PDT treatments was two (range 1-3). Conclusions: The vaso-occlusive effect of PDT combined with the vasostatic and antiinflammatory effect of systemic oral prednisolone appears to be a safe and effective option in the primary treatment of subfoveal CNV in patients with PIC.

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