Head Trauma The Untold Story of Common

Recreational Injuries

Stefan Hagopian DO FAAO

OPSC 2018 Annual Convention

San Diego CA

Feb 23 2018

bull TRAUMA ndash

GENERAL

bull RECREATIONAL vs ACCIDENTAL TRAUMA

bull HIGH RISK OF RECREATIONAL TRAUMA

bull TRAUMATIC BRAIN (Head) INJURY (ldquoTBIrdquo)

TRAUMA ‐

GENERALbull Assaultbull Motor Vehiclebull Natural Disasterbull Social Upheavalbull Warbull Home or Work Accidentbull Machinery or Structural Failurebull OCCUPATIONAL Impacts or Strainsbull RECREATIONAL Impacts or Strains

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

jogging gym yoga pilates horseriding

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

touring bike hikeclimb dive ski boat

bull THRILL‐SEEKING ‐

sky‐dive surf bungee cliff‐dive

UNTOLD

UNPOPULAR

UNWANTED

UNDENIABLE

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

bull TRAUMA ndash

GENERAL

bull RECREATIONAL vs ACCIDENTAL TRAUMA

bull HIGH RISK OF RECREATIONAL TRAUMA

bull TRAUMATIC BRAIN (Head) INJURY (ldquoTBIrdquo)

TRAUMA ‐

GENERALbull Assaultbull Motor Vehiclebull Natural Disasterbull Social Upheavalbull Warbull Home or Work Accidentbull Machinery or Structural Failurebull OCCUPATIONAL Impacts or Strainsbull RECREATIONAL Impacts or Strains

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

jogging gym yoga pilates horseriding

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

touring bike hikeclimb dive ski boat

bull THRILL‐SEEKING ‐

sky‐dive surf bungee cliff‐dive

UNTOLD

UNPOPULAR

UNWANTED

UNDENIABLE

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

TRAUMA ‐

GENERALbull Assaultbull Motor Vehiclebull Natural Disasterbull Social Upheavalbull Warbull Home or Work Accidentbull Machinery or Structural Failurebull OCCUPATIONAL Impacts or Strainsbull RECREATIONAL Impacts or Strains

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

jogging gym yoga pilates horseriding

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

touring bike hikeclimb dive ski boat

bull THRILL‐SEEKING ‐

sky‐dive surf bungee cliff‐dive

UNTOLD

UNPOPULAR

UNWANTED

UNDENIABLE

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

jogging gym yoga pilates horseriding

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

touring bike hikeclimb dive ski boat

bull THRILL‐SEEKING ‐

sky‐dive surf bungee cliff‐dive

UNTOLD

UNPOPULAR

UNWANTED

UNDENIABLE

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

UNTOLD

UNPOPULAR

UNWANTED

UNDENIABLE

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Most RECREATIONAL TRAUMA is AcceptedAllowed because it is INFREQUENT or BENIGN

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

INFREQUENT

bull Severe Trauma is INFREQUENT

bull Accidental Mishap is INFREQUENT

bull Few Participants in Very Few Encounters

bull Socially Accepted Habits = Difficult to Change

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

BENIGN

bull Benign Musculo‐Skeletal Strains or Impacts

bull Benign Long‐Term Sequelae Osteoarthritis etc

bull Benign Consequences = Unmotivated to Change

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Splitting the Falx Cerebri

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

RECREATIONAL TRAUMA

bull SPORTS ‐

teamindividual competitive or performance

bull EXERCISE ‐

bull AMUSEMENT ‐

parksrides musicdancing substances

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

RECREATIONAL TRAUMA

bull SPORTS ‐‐‐‐‐‐‐‐‐‐‐

SOCCER

bull EXERCISE ‐

bull AMUSEMENT ‐‐‐‐

ROLLER COASTER RIDES

bull SIGHT‐SEEING ‐

bull THRILL‐SEEKING ‐

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

The Untold Story of Traumatic Brain Injury in

Soccer and Amusement Rides

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff

GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser

JT Kessels

AG Lezak

MD Troost

J

J Clin

Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall

DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim

TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl

1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg

D Leclerc

S Couture S Daigle C

Clin

J Sport Med 2007 Sep 17(5)369‐74

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek

RJ Roberts DJ

Ann Emerg

Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg

Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim

Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj

Prev 2005 Oct 11(5)309‐12

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

SOCCER

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

SOCCERbull 265 MM Soccer Players Worldwide

bull 3 MM Youth Soccer Players in US is 1 Sport

bull HEADING the Ball as Regular Part of Game

bull No Protectionbull Medical Literature Dates Back gt30 Years

bull Documented Adverse Effects CTE Etc

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

SOCCERbull BALL Travels at High Speed amp Long Distance in Air

bull ldquoHeading the Ballrdquo

RARELY Occurs Smoothly

bull Force of Ball Impact ENTERS the Head

bull INJURY Results to Brain Meninges amp Cranium

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

AMUSEMENT RIDES

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

ROLLER COASTER

bull 300 MM Riders Annually 4 deathsyr averaged lsquo94‐rsquo049200 children in ERrsquosyr in lsquo08 diag code Amus Pk

bull Mishaps amp Accidents are Rare ndash

Misleading

bull Regular Mild Concussions for the Vulnerable (consider football player vs young child)

bull Measurable Decreases in GH Levels

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

ROLLER COASTER Etcbull Amusement Park Rider in Any THRILL Ride

bull SUDDEN Change in Direction Delivers ldquoShear Forcerdquo

bull Whiplash injury to BRAIN is ldquoCoup‐Contracouprdquo

bull BIG AccelerationDeceleration Delivers ldquoG Forcesrdquo

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

NFL Now Allows NO IMPACTS TO HEAD

bull 2017 had 281 reported incidents of CONCUSSION in preseason amp reg season

bull Most since NFL began releasing those statistics in 2012

bull Often went undetected or unreported previously no protocols and impacts to head were allowed

in ruleshellip

bull PRESENTLY NOT ALLOWED to hit to the head or to hit WITH the head

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Literature References ‐

AmusementAmusement park injuries and deaths

Braksiek RJ Roberts DJ

Ann Emerg Med 2002 Jan 39(1)65‐72

Roller coaster headaches revisited

Huang PP

Surg Neurol 2003 Nov 60(5)398‐401

Waiver of Consent in Studies of Acute Brain Injury

Guy L Clifton

Paula Knudson

Marilyn McDonald

Journal of Neurotrauma

Jul 2004 1121‐1126

Head Accelerations Experienced during Everyday Activities and While Riding Roller Coasters

Steven R Arndt

Robert S Cargill

P E Selim Hammoud

Proceedings of the Human Factors and Ergonomics Society Annual Meeting Sep 2004 Vol 48 No 16 1973‐

1977

Deformation of the Human Brain Induced by Mild Acceleration

PV Bayly

TS Cohen

EP Leister

D Ajo

EC Leuthardt

GM Genin

Journal of Neurotrauma

Aug 2005 845‐856

Roller coaster related fatalities United States 1994‐‐2004

Pelletier AR Gilchrist J

Inj Prev 2005 Oct 11(5)309‐12

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Emergency department visits secondary to amusement ride injuries

in children

Loder RT Feinberg JR

J Pediatr Orthop 2008 Jun 28(4)423‐6

Measurements of Non‐Injurious Head Accelerations of a Pediatric Population

William R Bussone

Tara L A Moore

Darrin Richards

Robert T Bove

Irving Scher

Michael T Prange

SAE International Journal of Passenger Cars ‐

Mechanical Systems 2009 Vol 2 No 1 565

Biomechanical Analysis of Experimental Diffuse Axonal Injury

DAVID F MEANEY

DOUGLAS H SMITH

DAVID I SHREIBER

ALLISON C BAIN

REID T MILLER

DOUG T

ROSS

THOMAS A GENNARELLI

Journal of Neurotrauma

Jan 2009 689‐694

Subacute subdural hematoma in a 45‐year‐old woman with no significant past medical history after a roller

coaster ride

Kim A Williams Jr

Pelagia Kouloumberis

Herbert H Engelhard

The American Journal of Emergency Medicine May 2009 Vol 27 No 4 517e5‐517e6

Human factors on the midway knowledge transfer and research opportunities for safety in the carnival and

theme park domains

Kathryn Woodcock

Sep 2009 945‐950

Head Motions While Riding Roller Coasters

Bryan J Pfister

Larry Chickola

Douglas H Smith

The American Journal of Forensic Medicine and Pathology Dec 2009 Vol 30 No 4 339‐345

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller

coaster ride ‐

case report and a review

Ozkan Arat Y Volpi J Arat A Klucznik R Diaz O

Ulus Travma Acil Cerrahi Derg 2011 Jan 17(1)75‐8

ROLLER COASTER‐ASSOCIATED RETINAL DETACHMENTS

Saad Shaikh

Retinal Cases amp Brief Reports Jan 2011 Vol 5 No 2 128‐129

Roller coaster‐associated subarachnoid hemorrhagemdashreport of 2 cases

Sebastian Rutsch

Wolf‐Dirk Niesen

Stephan Meckel

Matthias Reinhard

Journal of the Neurological Sciences Apr 2012 Vol 315 No 1‐2 164‐166

Neurologic complication after a roller coaster ride

Sa Leitao D Mendonca D Iyer H Kao CK

Am J Emerg Med 2012 Jan 30(1)249e5‐7 Epub 2010 Oct 25

Three cases of cervicocephalic artery dissection in an amusement

park

Kurita N Ueno Y Watanabe M Miyamoto N Shimura H Nonaka S Tsutsumi S Yasumoto Y Hattori N Urabe

T

J Stroke Cerebrovasc Dis 2014 Nov‐Dec 23(10)e467‐71 Epub 2014 Sep 26

Internal carotid artery dissection after a roller coaster ride in a 4‐year‐old case report and review of the

literature

Nouh A1

Vela‐Duarte D2

Grobelny T3

Hoganson G4

Pasquale D5

Biller J6

Pediatr Neurol

2015 Mar52(3)349‐51 doi 101016jpediatrneurol201411007 Epub 2014 Nov 26

Effects of Horizontal Acceleration on Human Visual Acuity and Stereopsis

Chi‐Ting Horng

Yih‐Shou Hsieh

Ming‐Ling Tsai

Wei‐Kang Chang

Tzu‐Hung Yang

Chien‐Han Yauan

Chih‐Hung

Wang

Wu‐Hsien Kuo

Yi‐Chang Wu

International Journal of Environmental Research and Public Health Dec 2015 Vol 12 No 12 910‐926

A Motion Simulator Ride Associated With Headache and Subdural Hematoma First Case Report

Robert A Scranton

Randolph W Evans

David S Baskin

Headache The Journal of Head and Face Pain Feb 2016 Vol 56 No 2 372‐378

Pilot Findings of Brain Displacements and Deformations during Roller Coaster Rides

Calvin Kuo

Lyndia C Wu

Patrick P Ye

Kaveh Laksari

David B Camarillo

Ellen Kuhl

Journal of Neurotrauma

Nov 2017 3198‐3205

Middle Cerebral Artery Stroke as Amusement Park Injury Case Report and Review of the Literature

Abby Baumgartle

Laura Wolfe

Vinay Puri

Karen Moeller

Salvatore Bertolone

Ashok Raj

Children Dec 2017 Vol 4 No 12 64

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser JT Kessels AG Lezak MD Troost J

J Clin Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl 1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg D Leclerc S Couture S Daigle C

Clin J Sport Med 2007 Sep 17(5)369‐74

Chronic traumatic encephalopathy in contact sports a systematic

review of all reported

pathological cases

Maroon JC Winkelman R Bost J Amos A Mathyssek C Miele V

PLoS One 2015

10(2)e0117338 Epub 2015 Feb 11

Effects of Soccer Heading on Brain Structure and Function

Rodrigues AC Lasmar RP Caramelli P

Front Neurol 2016 738 Epub 2016 Mar 21

Soccer (Football Association) and chronic traumatic encephalopathy A short review and

recommendation

Nitrini R

Dement Neuropsychol 2017 Jul‐Sep 11(3)218‐220

• Head TraumaThe Untold Story of Common Recreational Injuries
• Slide Number 2
• TRAUMA - GENERAL
• RECREATIONAL TRAUMA
• UNTOLDUNPOPULARUNWANTEDUNDENIABLE
• Most RECREATIONAL TRAUMA isAcceptedAllowed because it is INFREQUENT or BENIGN
• INFREQUENT
• BENIGN
• Slide Number 9
• Slide Number 10
• Splitting the Falx Cerebri
• Slide Number 12
• Slide Number 13
• Slide Number 14
• Slide Number 15
• RECREATIONAL TRAUMA
• RECREATIONAL TRAUMA
• The Untold Story ofTraumatic Brain Injury in Soccer and Amusement Rides
• Literature of References - Soccer
• Literature References - Amusement
• SOCCER
• SOCCER
• SOCCER
• AMUSEMENT RIDES
• ROLLER COASTER
• ROLLER COASTER Etc
• NFL Now Allows NO IMPACTS TO HEAD
• Slide Number 28
• Literature References - Amusement
• Slide Number 30
• Slide Number 31
• Slide Number 32
• Literature of References - Soccer
• Slide Number 34

Literature of References ‐

SoccerIs heading a soccer ball injurious to brain functionBaroff GS

J Head Trauma Rehabil 1998 Apr 13(2)45‐52

A dose‐response relation of headers and concussions with cognitive impairment in professional soccer

playersMatser JT Kessels AG Lezak MD Troost J

J Clin Exp Neuropsychol 2001 Dec 23(6)770‐4

Heading and head injuries in soccerKirkendall DT Jordan SE Garrett WE

Sports Med 2001 31(5)369‐86

Effects of heading exposure and previous concussions on neuropsychological performance among

Norwegian elite footballersStraume‐Naesheim TM Andersen TE Dvorak J Bahr R

Br J Sports Med 2005 Aug 39 Suppl 1i70‐7

Prolonged neuropsychological impairments following a first concussion in female university soccer

athletesEllemberg D Leclerc S Couture S Daigle C

Clin J Sport Med 2007 Sep 17(5)369‐74

Chronic traumatic encephalopathy in contact sports a systematic

review of all reported

pathological cases

Maroon JC Winkelman R Bost J Amos A Mathyssek C Miele V

PLoS One 2015

10(2)e0117338 Epub 2015 Feb 11

Effects of Soccer Heading on Brain Structure and Function

Rodrigues AC Lasmar RP Caramelli P

Front Neurol 2016 738 Epub 2016 Mar 21

Soccer (Football Association) and chronic traumatic encephalopathy A short review and

recommendation

Nitrini R

Dement Neuropsychol 2017 Jul‐Sep 11(3)218‐220

• Head TraumaThe Untold Story of Common Recreational Injuries
• Slide Number 2
• TRAUMA - GENERAL
• RECREATIONAL TRAUMA
• UNTOLDUNPOPULARUNWANTEDUNDENIABLE
• Most RECREATIONAL TRAUMA isAcceptedAllowed because it is INFREQUENT or BENIGN
• INFREQUENT
• BENIGN
• Slide Number 9
• Slide Number 10
• Splitting the Falx Cerebri
• Slide Number 12
• Slide Number 13
• Slide Number 14
• Slide Number 15
• RECREATIONAL TRAUMA
• RECREATIONAL TRAUMA
• The Untold Story ofTraumatic Brain Injury in Soccer and Amusement Rides
• Literature of References - Soccer
• Literature References - Amusement
• SOCCER
• SOCCER
• SOCCER
• AMUSEMENT RIDES
• ROLLER COASTER
• ROLLER COASTER Etc
• NFL Now Allows NO IMPACTS TO HEAD
• Slide Number 28
• Literature References - Amusement
• Slide Number 30
• Slide Number 31
• Slide Number 32
• Literature of References - Soccer
• Slide Number 34

Chronic traumatic encephalopathy in contact sports a systematic

review of all reported

pathological cases

Maroon JC Winkelman R Bost J Amos A Mathyssek C Miele V

PLoS One 2015

10(2)e0117338 Epub 2015 Feb 11

Effects of Soccer Heading on Brain Structure and Function

Rodrigues AC Lasmar RP Caramelli P

Front Neurol 2016 738 Epub 2016 Mar 21

Soccer (Football Association) and chronic traumatic encephalopathy A short review and

recommendation

Nitrini R

Dement Neuropsychol 2017 Jul‐Sep 11(3)218‐220

• Head TraumaThe Untold Story of Common Recreational Injuries
• Slide Number 2
• TRAUMA - GENERAL
• RECREATIONAL TRAUMA
• UNTOLDUNPOPULARUNWANTEDUNDENIABLE
• Most RECREATIONAL TRAUMA isAcceptedAllowed because it is INFREQUENT or BENIGN
• INFREQUENT
• BENIGN
• Slide Number 9
• Slide Number 10
• Splitting the Falx Cerebri
• Slide Number 12
• Slide Number 13
• Slide Number 14
• Slide Number 15
• RECREATIONAL TRAUMA
• RECREATIONAL TRAUMA
• The Untold Story ofTraumatic Brain Injury in Soccer and Amusement Rides
• Literature of References - Soccer
• Literature References - Amusement
• SOCCER
• SOCCER
• SOCCER
• AMUSEMENT RIDES
• ROLLER COASTER
• ROLLER COASTER Etc
• NFL Now Allows NO IMPACTS TO HEAD
• Slide Number 28
• Literature References - Amusement
• Slide Number 30
• Slide Number 31
• Slide Number 32
• Literature of References - Soccer
• Slide Number 34