Intracranial Pressure After Soccer Heading

Abstract

OBJECTIVETo evaluate the effect of soccer heading on intracranial pressure (ICP) in trained athletes.METHODSEight subjects (all male, 21.7±1.7 years) were recruited from the UC San Diego soccer team. ICP and cardiovascular variables were recorded before and after 6 repeats of heading a soccer ball kicked from 35 yards away, into a goal. ICP was estimated non‐invasively from acoustical evoked tympanic membrane displacement (Vm), where a more negative volume displacement is correlated with higher ICP. Mean arterial pressure (MAP), heart rate (HR; Nexfin, Netherlands), and ICP were recorded in three different postures, 15° head up tilt (HUT), 0° supine, −15° head down tilt (HDT), in a randomized order.RESULTSMean Vm at 15° HUT was 37.81±133.21 nL at baseline and −20.82±158.27 nL immediately post soccer heading (P=0.0482, paired t test), analogous to an increased ICP. At 0° supine, mean Vm was −46.19±178.50 nL at baseline and −84.27±183.55 nL after impact (P=0.0321, paired t test). At −15° HDT, mean Vm was −148.48±196.07 nL at baseline and −187.02±186.19 nL immediately post soccer heading (P=0.1176, paired t test). MAP and HR did not significantly change between the baseline and post soccer heading measurements.DISCUSSIONAfter repeated soccer ball heading, ICP significantly increased at 15° HUT and 0° supine, while ICP at −15° HDT, MAP and HR did not significantly change. The relative increase in ICP associated with HDT is comparable to previously described trends. Although the measurement technique currently employed does not provide an absolute ICP baseline, the technique has been established as useful in evaluating relative changes. Under that interpretation, these results reflect what may be an elevated ICP related to soccer heading impacts. Accordingly, the results of this study suggest a potential health risk of participation in head contact sports.Support or Funding InformationNASA (80NSSC19K0020) and Novo Nordic Foundation (NNF16OC0019196)Soccer Heading Increases Intracranial Pressure at Head Up Tilt and Supine PositionsVolume displacement of tympanic membrane (Vm), measured non‐invasively from acoustical evoked tympanic membrane displacement, indicated an increase in intracranial pressure (ICP) after soccer heading at 15° head up tilt (HUT) and 0° supine (n = 8, paired t test, *P < 0.05). No significant increase in ICP at −15° head down tilt (HDT) was observed after soccer heading.Figure 1