{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:07:25Z","timestamp":1779527245965,"version":"3.53.1"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Baseball and softball pose unique risks for sport-related concussion (SRC). Although these are not collision sports, concussions in baseball and softball can nonetheless involve high-speed impacts. In a regional, single-institution cohort of baseball and softball athletes who sustained an SRC, the current study sought to 1) describe the mechanisms of injury that led to SRC, and 2) compare initial symptom burden and recovery metrics across mechanisms, including time to return to learn (RTL), time to symptom resolution, and time to return to play (RTP) by mechanism of injury.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective cohort study was performed of baseball and softball athletes 12 to 23 years old who sustained an SRC between November 2017 and April 2022. Mechanisms of injury were divided into two categories: 1) contact mechanism (i.e., what initiated contact with the injured player, such as head-to-ball), and 2) player mechanism (i.e., the action the injured player was performing at the time of injury, such as fielding). The recovery outcomes of time to RTL, symptom resolution, and RTP were compared between mechanisms using bivariate analysis and multivariable regression analysis, controlling for sex, age, time to present to concussion clinic, and initial total symptom score.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The sample included 58 baseball and softball players (60.3% female, mean age 16.0 \u00b1 1.9 years). Most SRCs (62.1%) occurred during competition. Head-to-ball (50.0%) was the most common contact mechanism, followed by head-to-head\/body (31.0%) and head-to-wall\/ground\/equipment (17.2%). Fielding (63.8%) was the most common player mechanism, followed by drills (20.7%) and running (13.8%). SRCs sustained in practice had significantly longer RTL (median 10.0 [interquartile range (IQR) 3.3\u201316.3] vs 4.0 [IQR 2.0\u20138.0] days; U = 421.5, p = 0.031) and symptom resolution (37.0 [IQR 18.0\u201390.0] vs 14.0 [IQR 7.0\u201341.0] days; U = 406.5, p = 0.025) compared with SRCs sustained in competition. Multivariable regression analysis revealed that head-to-wall\/ground\/equipment contact mechanism was associated with longer RTL (\u03b2 = 0.30, 95% CI 0.07\u20130.54, p = 0.013).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The current study found that SRCs in baseball and softball occurred more often in competition than in practice. Head-to-ball and fielding were the most common contact and player mechanisms, respectively. SRCs sustained in practice were associated with longer time to RTL and symptom resolution, and head-to-wall\/ground\/equipment was associated with longer RTL in multivariable regression analysis. These results provide empirical data to improve concussion safety in baseball\/softball.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.4.focus24144","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T14:52:22Z","timestamp":1720018342000},"page":"E13","source":"Crossref","is-referenced-by-count":1,"title":["Sport-related concussions in baseball and softball: do mechanisms of injury affect recovery?"],"prefix":"10.3171","volume":"57","author":[{"given":"John E.","family":"Dugan","sequence":"first","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"},{"name":"University of Tennessee Health Science Center, College of Medicine, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor C.","family":"Long","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"},{"name":"East Tennessee State University, James H. Quillen College of Medicine, Johnson City;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Sills","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Jo","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"},{"name":"Vanderbilt University School of Medicine, Nashville; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"},{"name":"Vanderbilt University School of Medicine, Nashville; and"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Vanderbilt Sport Concussion Center, Nashville;"},{"name":"Vanderbilt University School of Medicine, Nashville; and"},{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Br J Sports Med","first-page":"695","article-title":"Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022","volume":"57","author":"Patricios JS","year":"2023","unstructured":"Patricios JS, Schneider KJ, Dvorak J, Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695\u2013711."},{"issue":"3","key":"b2","series-title":"J Athl Train","first-page":"299","article-title":"A physiological approach to prolonged recovery from sport-related concussion","volume":"52","author":"Leddy J","year":"2017","unstructured":"Leddy J, Baker JG, Haider MN, Hinds A, Willer B. A physiological approach to prolonged recovery from sport-related concussion. J Athl Train. 2017;52(3):299\u2013308."},{"issue":"12","key":"b3","series-title":"Br J Sports Med","first-page":"941","article-title":"Predictors of clinical recovery from concussion: a systematic review","volume":"51","author":"Iverson GL","year":"2017","unstructured":"Iverson GL, Gardner AJ, Terry DP, Predictors of clinical recovery from concussion: a systematic review. Br J Sports Med. 2017;51(12):941\u2013948."},{"issue":"12","key":"b4","series-title":"Br J Sports Med","first-page":"798","article-title":"Clinical recovery from concussion-return to school and sport: a systematic review and meta-analysis","volume":"57","author":"Putukian M","year":"2023","unstructured":"Putukian M, Purcell L, Schneider KJ, Clinical recovery from concussion-return to school and sport: a systematic review and meta-analysis. Br J Sports Med. 2023;57(12):798\u2013809."},{"issue":"24","key":"b5","series-title":"Neurology","first-page":"2204","article-title":"Early symptom burden predicts recovery after sport-related concussion","volume":"83","author":"Meehan WP III","year":"2014","unstructured":"Meehan WP III, Mannix R, Monuteaux MC, Stein CJ, Bachur RG. Early symptom burden predicts recovery after sport-related concussion. Neurology. 2014;83(24):2204\u20132210."},{"issue":"3","key":"b6","series-title":"J Pediatr","first-page":"721","article-title":"Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not","volume":"163","author":"Meehan WP III","year":"2013","unstructured":"Meehan WP III, Mannix RC, Stracciolini A, Elbin RJ, Collins MW. Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not. J Pediatr. 2013;163(3):721\u2013725."},{"key":"b7","series-title":"J Pediatr","first-page":"33","article-title":"Specific factors influence postconcussion symptom duration among youth referred to a sports concussion clinic","volume":"174","author":"Heyer GL","year":"2016","unstructured":"Heyer GL, Schaffer CE, Rose SC, Young JA, McNally KA, Fischer AN. Specific factors influence postconcussion symptom duration among youth referred to a sports concussion clinic. 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Orthop J Sports Med. 2021;9(12):23259671211052585."},{"issue":"2","key":"b13","series-title":"Orthop J Sports Med","first-page":"2325967119825660","article-title":"A retrospective analysis of softball-related head and facial injuries treated in United States emergency departments, 2013-2017","volume":"7","author":"Strickland JS","year":"2019","unstructured":"Strickland JS, Crandall M, Bevill GR. A retrospective analysis of softball-related head and facial injuries treated in United States emergency departments, 2013-2017. Orthop J Sports Med. 2019;7(2):2325967119825660."},{"key":"b14","series-title":"Front Neurol","first-page":"492","article-title":"Systematic review of traumatic brain injuries in baseball and softball: a framework for prevention","volume":"8","author":"Cusimano MD","year":"2017","unstructured":"Cusimano MD, Zhu A. Systematic review of traumatic brain injuries in baseball and softball: a framework for prevention. 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