{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T10:16:07Z","timestamp":1774520167212,"version":"3.50.1"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006942","name":"Medical University of South Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006942","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surfing's Olympic inclusion has spotlighted it as an internationally popular, high-impact sport with risks of neurosurgical-relevant trauma. However, research on these injuries remains sparse and heterogenous and no synthesis has mapped this literature. All athletic levels of surfers face unique biomechanical forces from wave impacts, board collisions, and seafloor contact, which results in a significant, yet under-quantified, neurotrauma prevalence. Despite parallels with other action sports, surfing-specific epidemiology, helmet efficacy, and standardized return-to-play guidelines remain underdeveloped, even within professional and collegiate athletic governing bodies like the World Surf League (WSL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A scoping review screening for head trauma in surfing was conducted and yielded 25 studies published between 1976 and 2025 encompassing 72,093 patients. Epidemiologic data, injury mechanisms, reported intracranial pathology, need for neurosurgical intervention, and protective equipment use was extracted and synthesized in Table\u00a01\n                      <jats:italic>.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our analysis of literature indicates an under quantified risk of neurosurgical-relevant trauma. Injuries include concussions and lacerations as the predominant mechanism of injury, and severe outcomes like skull fractures and intracranial hemorrhages, reported at 0.8\u20131.9% of large ED cohorts, which occasionally require neurosurgical intervention and, rarely, result in mortality. Direct surfboard impact is the predominant injury mechanism, estimated in one dataset to account for up to 55% of emergency department presentations. Higher rates of head injury were observed among pediatric surfers and those able to perform advanced maneuvers. Helmet use was inconsistently reported, noted in 11\/25 studies, and its efficacy largely unevaluated. A critical finding is the complete absence of validated return-to-play guidelines in the reviewed literature. The prevalence of surfing injury is substantially underreported due to methodological limitations in existing studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review underscores an urgent need for standardized injury surveillance, rigorous protective gear research, evidence-based concussion management frameworks, and heightened neurosurgical awareness of the risks inherent to this growing global sport.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-026-06844-0","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:57:56Z","timestamp":1774454276000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating head and neck trauma in surfing: injuries and prevention in an olympic sport"],"prefix":"10.1007","volume":"168","author":[{"given":"Caleb","family":"Ratz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parker","family":"Dhillon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian Fabian","family":"Saway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Al-Batryni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liz","family":"Iglesias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Spiotta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kalhorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"6844_CR1","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.jss.2020.08.009","volume":"257","author":"EJ Alfrey","year":"2021","unstructured":"Alfrey EJ, Tracy M, Alfrey JR, Carroll M, Aranda-Wikman ED, Arora T et al (2021) Helmet usage reduces serious head injury without decreasing concussion after bicycle riders crash. J Surg Res 257:593\u2013596. https:\/\/doi.org\/10.1016\/j.jss.2020.08.009","journal-title":"J Surg Res"},{"key":"6844_CR2","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1001\/jama.1977.03270340054020","volume":"237","author":"RH Allen","year":"1977","unstructured":"Allen RH, Eiseman B, Straehley CJ, Orloff BG (1977) Surfing injuries at Waikiki. JAMA 237:668\u2013670","journal-title":"JAMA"},{"key":"6844_CR3","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1111\/sms.12699","volume":"27","author":"N Bailly","year":"2017","unstructured":"Bailly N, Llari M, Donnadieu T, Masson C, Arnoux PJ (2017) Head impact in a snowboarding accident. Scand J Med Sci Sports 27:964\u2013974. https:\/\/doi.org\/10.1111\/sms.12699","journal-title":"Scand J Med Sci Sports"},{"issue":"1","key":"6844_CR4","doi-asserted-by":"publisher","first-page":"i56","DOI":"10.1136\/bjsm.2009.058271","volume":"43","author":"BW Benson","year":"2009","unstructured":"Benson BW, Hamilton GM, Meeuwisse WH, McCrory P, Dvorak J (2009) Is protective equipment useful in preventing concussion? A systematic review of the literature. Br J Sports Med 43(1):i56-67. https:\/\/doi.org\/10.1136\/bjsm.2009.058271","journal-title":"Br J Sports Med"},{"key":"6844_CR5","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v7.i12.814","volume":"7","author":"CJV Bergen","year":"2016","unstructured":"Bergen CJV, Commandeur JP, Weber RI, Haverkamp D, Breederveld RS (2016) Windsurfing vs kitesurfing: injuries at the North Sea over a 2-year period. World J Orthop 7:814. https:\/\/doi.org\/10.5312\/wjo.v7.i12.814","journal-title":"World J Orthop"},{"key":"6844_CR6","unstructured":"Coen J (2015) Break breakdown: tackling tubes at Teahupo\u2019o [Internet]. World Surf Leag. [cited 2025 June 19]. https:\/\/www.worldsurfleague.com\/posts\/130792\/break-breakdown-billabong-pro-tahiti. Accessed 19 June 2025"},{"key":"6844_CR7","doi-asserted-by":"publisher","first-page":"1730","DOI":"10.1097\/SCS.0000000000008614","volume":"33","author":"B Davidov","year":"2022","unstructured":"Davidov B, Leibovitch I, Mezad-Koursh D, Feldman I, Cnaan RB (2022) Surfboard related orbital and periocular injury. J Craniofac Surg 33:1730\u20131733. https:\/\/doi.org\/10.1097\/SCS.0000000000008614","journal-title":"J Craniofac Surg"},{"key":"6844_CR8","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1080\/2159676X.2019.1657930","volume":"12","author":"NA Dean","year":"2020","unstructured":"Dean NA, Bundon A (2020) \u2018You\u2019re only falling into water!\u2019: exploring surfers\u2019 understandings of concussion in Canadian surf culture. Qual Res Sport Exerc Health 12:579\u2013596. https:\/\/doi.org\/10.1080\/2159676X.2019.1657930","journal-title":"Qual Res Sport Exerc Health"},{"key":"6844_CR9","doi-asserted-by":"publisher","first-page":"2805","DOI":"10.1007\/s10439-021-02723-0","volume":"49","author":"G DiGiacomo","year":"2021","unstructured":"DiGiacomo G, Tsai S, Bottlang M (2021) Impact performance comparison of advanced snow sport helmets with dedicated rotation-damping systems. Ann Biomed Eng 49:2805\u20132813. https:\/\/doi.org\/10.1007\/s10439-021-02723-0","journal-title":"Ann Biomed Eng"},{"key":"6844_CR10","doi-asserted-by":"publisher","first-page":"1246","DOI":"10.1177\/0363546514567062","volume":"43","author":"J Furness","year":"2015","unstructured":"Furness J, Hing W, Walsh J, Abbott A, Sheppard JM, Climstein M (2015) Acute injuries in recreational and competitive surfers: incidence, severity, location, type, and mechanism. Am J Sports Med 43:1246\u20131254. https:\/\/doi.org\/10.1177\/0363546514567062","journal-title":"Am J Sports Med"},{"key":"6844_CR11","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.12334","volume":"9","author":"J Furness","year":"2021","unstructured":"Furness J, McArthur K, Remnant D, Jorgensen D, Bacon CJ, Moran RW et al (2021) Traumatic surfing injuries in New Zealand: a descriptive epidemiology study. PeerJ 9:e12334. https:\/\/doi.org\/10.7717\/peerj.12334","journal-title":"PeerJ"},{"key":"6844_CR12","first-page":"272","volume":"18","author":"S Grunner","year":"2016","unstructured":"Grunner S, Kotlarsky P, Berkovich Y, Givon A, Keren Y (2016) Epidemiology of kite surfing injuries among recreational athletes. Isr Med Assoc J 18:272\u2013274","journal-title":"Isr Med Assoc J"},{"key":"6844_CR13","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1016\/j.renene.2020.03.124","volume":"155","author":"N Guillou","year":"2020","unstructured":"Guillou N, Elsevier (2020) Estimating wave energy flux from significant wave height and peak period. Renew Energy 155:1383\u20131393","journal-title":"Renew Energy"},{"key":"6844_CR14","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/JES.0b013e318201f53e","volume":"39","author":"KM Guskiewicz","year":"2011","unstructured":"Guskiewicz KM, Mihalik JP (2011) Biomechanics of sport concussion: quest for the elusive injury threshold. Exerc Sport Sci Rev 39:4\u201311. https:\/\/doi.org\/10.1097\/JES.0b013e318201f53e","journal-title":"Exerc Sport Sci Rev"},{"key":"6844_CR15","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1136\/bmj.38314.480035.7C","volume":"330","author":"BE Hagel","year":"2005","unstructured":"Hagel BE, Pless IB, Goulet C, Platt RW, Robitaille Y (2005) Effectiveness of helmets in skiers and snowboarders: case-control and case crossover study. BMJ 330:281. https:\/\/doi.org\/10.1136\/bmj.38314.480035.7C","journal-title":"BMJ"},{"key":"6844_CR16","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1016\/j.injury.2023.03.011","volume":"54","author":"M Hager","year":"2023","unstructured":"Hager M, Leavitt J, Carballo C, Gratton A, Yon J (2023) Surfing injuries: a US epidemiological study from 2009\u20132020. Injury 54:1541\u20131545. https:\/\/doi.org\/10.1016\/j.injury.2023.03.011","journal-title":"Injury"},{"key":"6844_CR17","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1580\/1080-6032-020.004.0335","volume":"20","author":"CSM Hay","year":"2009","unstructured":"Hay CSM, Barton S, Sulkin T (2009) Recreational surfing injuries in Cornwall, United Kingdom. Wilderness Environ Med 20:335\u2013338. https:\/\/doi.org\/10.1580\/1080-6032-020.004.0335","journal-title":"Wilderness Environ Med"},{"key":"6844_CR18","unstructured":"Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, Moschetti I, Phillips B, Thornton H (n.d.) The 2011 Oxford CEBM Evidence Levels of Evidence (Introductory Document). Oxford Centre for Evidence-Based Medicine. https:\/\/www.cebm.net\/index.aspx?o=5653. Accessed 28 Nov 2025"},{"key":"6844_CR19","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.jdmm.2016.09.009","volume":"7","author":"N Hritz","year":"2018","unstructured":"Hritz N, Franzidis AF (2018) Exploring the economic significance of the surf tourism market by experience level. J Destin Mark Manage 7:164\u2013169. https:\/\/doi.org\/10.1016\/j.jdmm.2016.09.009","journal-title":"J Destin Mark Manage"},{"key":"6844_CR20","doi-asserted-by":"publisher","first-page":"S233","DOI":"10.1097\/SAP.0000000000001026","volume":"78","author":"KT Jubbal","year":"2017","unstructured":"Jubbal KT, Chen C, Costantini T, Herrera F, Dobke M, Suliman A (2017) Analysis of surfing injuries presenting in the acute trauma setting. Ann Plast Surg 78:S233\u2013S237. https:\/\/doi.org\/10.1097\/SAP.0000000000001026","journal-title":"Ann Plast Surg"},{"key":"6844_CR21","doi-asserted-by":"publisher","DOI":"10.1098\/rsfs.2024.0055","volume":"15","author":"S Jung","year":"2025","unstructured":"Jung S (2025) Water entry and exit in nature: review. Interface Focus 15:20240055. https:\/\/doi.org\/10.1098\/rsfs.2024.0055","journal-title":"Interface Focus"},{"key":"6844_CR22","doi-asserted-by":"publisher","first-page":"707","DOI":"10.5694\/j.1326-5377.1976.tb128237.x","volume":"2","author":"M Kennedy","year":"1976","unstructured":"Kennedy M, Vanderfield G (1976) Medical aspects of surfcraft usage. Med J Aust 2:707\u2013709. https:\/\/doi.org\/10.5694\/j.1326-5377.1976.tb128237.x","journal-title":"Med J Aust"},{"key":"6844_CR23","doi-asserted-by":"publisher","unstructured":"Kleiven S (2013) Why Most Traumatic brain injuries are not caused by linear acceleration but skull fractures are. Front Bioeng Biotechnol [Internet]. [cited 2025 June 19];1. https:\/\/doi.org\/10.3389\/fbioe.2013.00015","DOI":"10.3389\/fbioe.2013.00015"},{"key":"6844_CR24","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1016\/j.ajem.2016.05.008","volume":"34","author":"C Klick","year":"2016","unstructured":"Klick C, Jones CMC, Adler D (2016) Surfing USA: an epidemiological study of surfing injuries presenting to US EDs 2002 to 2013. Am J Emerg Med 34:1491\u20131496. https:\/\/doi.org\/10.1016\/j.ajem.2016.05.008","journal-title":"Am J Emerg Med"},{"key":"6844_CR25","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.jor.2019.11.042","volume":"19","author":"BU Kozminski","year":"2020","unstructured":"Kozminski BU, Ahmed N, Cautela FS, Shah NV, Shangguan X, Doran JP et al (2020) Surfing-related head injuries presenting to United States emergency departments. J Orthop 19:184\u20138. https:\/\/doi.org\/10.1016\/j.jor.2019.11.042","journal-title":"J Orthop"},{"key":"6844_CR26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285928","volume":"18","author":"JC Lawes","year":"2023","unstructured":"Lawes JC, Koon W, Berg I, Van De Schoot D, Peden AE, Li X (2023) The epidemiology, risk factors and impact of exposure on unintentional surfer and bodyboarder deaths. PLoS ONE 18:e0285928. https:\/\/doi.org\/10.1371\/journal.pone.0285928","journal-title":"PLoS ONE"},{"issue":"5","key":"6844_CR27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285928","volume":"18","author":"JC Lawes","year":"2023","unstructured":"Lawes JC, Koon W, Berg I, van de Schoot D, Peden AE (2023) The epidemiology, risk factors and impact of exposure on unintentional surfer and bodyboarder deaths. PLoS One 18(5):e0285928. https:\/\/doi.org\/10.1371\/journal.pone.0285928","journal-title":"PLoS One"},{"key":"6844_CR28","unstructured":"Lewis T (2023) \u2018I\u2019ve lived many lifetimes\u2019: surfer Owen Wright\u2019s remarkable journey from brain injury to Olympic glory. The Guardian [Internet].\u00a0 [cited 2025 June 19]; https:\/\/www.theguardian.com\/sport\/2023\/oct\/08\/ive-lived-many-lifetimes-surfer-owen-wrights-remarkable-journey-from-brain-injury-to-olympic-glory. Accessed 19 June 2025"},{"key":"6844_CR29","first-page":"651","volume":"93","author":"JA Liver","year":"1965","unstructured":"Liver JA, Wiley JJ (1965) Surfing injuries. Can Med Assoc J 93:651\u2013652","journal-title":"Can Med Assoc J"},{"key":"6844_CR30","doi-asserted-by":"publisher","first-page":"613","DOI":"10.5694\/j.1326-5377.1983.tb122722.x","volume":"2","author":"BJ Lowdon","year":"1983","unstructured":"Lowdon BJ, Pateman NA, Pitman AJ (1983) Surfboard-riding injuries. Med J Aust 2:613\u2013616. https:\/\/doi.org\/10.5694\/j.1326-5377.1983.tb122722.x","journal-title":"Med J Aust"},{"key":"6844_CR31","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.1016\/j.ajem.2020.06.091","volume":"38","author":"T Lurie","year":"2020","unstructured":"Lurie T, Schwartz B, Najafali D, Gandhi P, Jackson M, Tran QK (2020) Correlation of history and physical examination with imaging in traumatic near-shore aquatic head and spinal injury. Am J Emerg Med 38:2049\u20132054. https:\/\/doi.org\/10.1016\/j.ajem.2020.06.091","journal-title":"Am J Emerg Med"},{"key":"6844_CR32","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1086\/229379","volume":"95","author":"S Lyng","year":"1990","unstructured":"Lyng S, The University of Chicago Press (1990) Edgework: a social psychological analysis of voluntary risk taking. Am J Sociol 95:851\u201386","journal-title":"Am J Sociol"},{"key":"6844_CR33","doi-asserted-by":"publisher","DOI":"10.3390\/sports8020025","volume":"8","author":"K McArthur","year":"2020","unstructured":"McArthur K, Jorgensen D, Climstein M, Furness J (2020) Epidemiology of acute injuries in surfing: type, location, mechanism, severity, and incidence: a systematic review. Sports 8:25. https:\/\/doi.org\/10.3390\/sports8020025","journal-title":"Sports"},{"key":"6844_CR34","doi-asserted-by":"publisher","unstructured":"Moola S, Munn Z, Tufunaru C, Aromataris E, Sears K, Sfetc R et al (2024) Systematic reviews of Aetiology and risk. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Man Evid Synth [Internet]. JBI; [cited 2025 June 18]. https:\/\/doi.org\/10.46658\/JBIMES-24-06","DOI":"10.46658\/JBIMES-24-06"},{"key":"6844_CR35","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1097\/SCS.0000000000008769","volume":"33","author":"EG Muhonen","year":"2022","unstructured":"Muhonen EG, Kafle S, Torabi SJ, Abello EH, Bitner BF, Pham N (2022) Surfing-related craniofacial injuries: a NEISS database study. J Craniofac Surg 33:2383\u20132387. https:\/\/doi.org\/10.1097\/SCS.0000000000008769","journal-title":"J Craniofac Surg"},{"key":"6844_CR36","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1053\/ajem.2002.32650","volume":"20","author":"A Nathanson","year":"2002","unstructured":"Nathanson A, Haynes P, Galanis D (2002) Surfing injuries. Am J Emerg Med 20:155\u2013160. https:\/\/doi.org\/10.1053\/ajem.2002.32650","journal-title":"Am J Emerg Med"},{"key":"6844_CR37","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1177\/0363546506293702","volume":"35","author":"A Nathanson","year":"2007","unstructured":"Nathanson A, Bird S, Dao L, Tam-Sing K (2007) Competitive surfing injuries: a prospective study of surfing-related injuries among contest surfers. Am J Sports Med 35:113\u2013117. https:\/\/doi.org\/10.1177\/0363546506293702","journal-title":"Am J Sports Med"},{"key":"6844_CR38","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1016\/j.injury.2022.03.045","volume":"53","author":"J Quinn","year":"2022","unstructured":"Quinn J, Salmon L, Ngo D, Taylor F, Platt S (2022) The epidemiology of surfing injuries in a major Australian centre \u2013 a ten year clinical audit. Injury 53:1887\u20131892. https:\/\/doi.org\/10.1016\/j.injury.2022.03.045","journal-title":"Injury"},{"key":"6844_CR39","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114564358","volume":"3","author":"VK Sharma","year":"2015","unstructured":"Sharma VK, Rango J, Connaughton AJ, Lombardo DJ, Sabesan VJ (2015) The current state of head and neck injuries in extreme sports. Orthop J Sports Med 3:2325967114564358. https:\/\/doi.org\/10.1177\/2325967114564358","journal-title":"Orthop J Sports Med"},{"key":"6844_CR40","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2024.101014","volume":"7","author":"EM Snyder","year":"2025","unstructured":"Snyder EM, Rooks EA, Obana KK, Chang SKY, Ahmad CS, Popkin CA et al (2025) Twenty-year analysis of surfing head and neck injuries presenting to United States emergency departments showed a decrease in overall injuries despite steady concussion rates. Arthrosc Sports Med Rehabil 7:101014. https:\/\/doi.org\/10.1016\/j.asmr.2024.101014","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"6844_CR41","unstructured":"Surfrider Foundation. Socioeconomic and Recreational Profile of Surfers in the United States [Internet]. Surfrider Foundation; 2011. https:\/\/public.surfrider.org\/files\/surfrider_report_v13.pdf"},{"key":"6844_CR42","first-page":"403","volume":"74","author":"C Swinney","year":"2015","unstructured":"Swinney C (2015) Assessing the prevalence of traumatic head injury amongst recreational surfers in the United States. Hawaii J Med Public Health J Asia Pac Med Public Health 74:403\u2013405","journal-title":"Hawaii J Med Public Health J Asia Pac Med Public Health"},{"key":"6844_CR43","doi-asserted-by":"publisher","first-page":"99","DOI":"10.2147\/OAJSM.S316642","volume":"12","author":"D Szymski","year":"2021","unstructured":"Szymski D, Achenbach L, Siebentritt M, Simoni K, Kuner N, Pfeifer C et al (2021) Injury epidemiology of 626 athletes in surfing, wind surfing and kite surfing. Open Access J Sports Med 12:99\u2013107. https:\/\/doi.org\/10.2147\/OAJSM.S316642","journal-title":"Open Access J Sports Med"},{"key":"6844_CR44","doi-asserted-by":"publisher","unstructured":"Tricco AC, Lillie E, Zarin W, O\u2019Brien KK, Colquhoun H, Levac D, American College of Physicians et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169:467\u201373. https:\/\/doi.org\/10.7326\/M18-0850","DOI":"10.7326\/M18-0850"},{"key":"6844_CR45","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevFluids.10.030502","volume":"10","author":"Q Wang","year":"2025","unstructured":"Wang Q, Zhang J, Bates D, Feng JJ, Yue P, Wu Q (2025) Fluid mechanical study of rotation-induced traumatic brain injury. Phys Rev Fluids 10:030502. https:\/\/doi.org\/10.1103\/PhysRevFluids.10.030502","journal-title":"Phys Rev Fluids"},{"key":"6844_CR46","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1097\/JSM.0000000000001271","volume":"34","author":"J Ward","year":"2024","unstructured":"Ward J, Haakonssen E, Parsonage J (2024) Concussion incidence, mechanism, and perspectives among Australian elite surfers: implications for medical support and safety protocols. Clin J Sport Med 34:591\u2013596. https:\/\/doi.org\/10.1097\/JSM.0000000000001271","journal-title":"Clin J Sport Med"},{"key":"6844_CR47","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231155884","volume":"11","author":"C Wende","year":"2023","unstructured":"Wende C, Lambert C, Hoeher J, Balke M (2023) Injuries and use of safety equipment in river surfing. Orthop J Sports Med 11:23259671231155884. https:\/\/doi.org\/10.1177\/23259671231155884","journal-title":"Orthop J Sports Med"},{"key":"6844_CR48","unstructured":"World Surf League (n.d.) 2024 WSL Rule Book (Updated BW). Published November 1, 2024. https:\/\/www.worldsurfleague.com\/asset\/39867\/2024+WSL+Rule+Book+(Updated+BW).pdf. Accessed June 19, 2025 [Internet]. [cited 2025 June 19]"},{"key":"6844_CR49","doi-asserted-by":"publisher","first-page":"2538.e1","DOI":"10.1016\/j.joms.2021.07.018","volume":"79","author":"SC Yang","year":"2021","unstructured":"Yang SC, Johnson DG, Keefe SH, Bast BT (2021) Aquatic activity-related craniofacial injuries presenting to United States emergency departments, 2010 to 2019. J Oral Maxillofac Surg 79:2538.e1-2538.e6. https:\/\/doi.org\/10.1016\/j.joms.2021.07.018","journal-title":"J Oral Maxillofac Surg"},{"key":"6844_CR50","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1115\/1.1691446","volume":"126","author":"L Zhang","year":"2004","unstructured":"Zhang L, Yang KH, King AI (2004) A proposed injury threshold for mild traumatic brain injury. J Biomech Eng 126:226\u2013236. https:\/\/doi.org\/10.1115\/1.1691446","journal-title":"J Biomech Eng"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-026-06844-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06844-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-026-06844-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T08:59:41Z","timestamp":1774515581000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-026-06844-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6844"],"URL":"https:\/\/doi.org\/10.1007\/s00701-026-06844-0","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"assertion":[{"value":"22 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No patients were involved in this review article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participation"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"IRB approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing\u00a0interests"}}],"article-number":"84"}}