Contraindications to participation in contact sports after a serious head injury:
(1) persistent postconcussion syndrome
(2) permanent central neurological sequelae from head injury, such as
(a) organic dementia
(b) hemiplegia
(c) homonymous hemianopsia
(3) hydrocephalus
(4) spontaneous subarachnoid hemorrhage from any cause
(5) intracranial hemorrhage requiring surgery
(6) symptomatic neurologic or pain-producing abnormalities about the foramen magnum
If a person makes a complete neurologic recovery following a life-threatening head injury and does not have any of the above conditions, then return to a contact sport may be possible. However:
(1) there should be no participation in a contact sport for at least 1 year
(2) there should be a careful deliberation on the pros and cons of such a decision and a review of alternative choices.
A person with a subdural hematoma or other hemorrhage requiring surgery should be discouraged from future participation in contact sports even if a complete neurological recovery occurs. A person who (a) had an epidural hematoma or a condition for which surgery was not required and (b) has made a complete neurological recovery sometimes can return to participation in contact sports, but only after waiting a year and after careful deliberation.
