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The debate over potential negative consequences from repeated head impacts associated with American football has critical implications for sport participation and the clinical management of current and former contact sport athletes. Public interest and media attention have focused largely on the late effects (both antemortem and postmortem) observed in individuals with multiple sport-related concussions. Age at first exposure to tackle football is of particular interest, given that youth participation can occur as early as 5 years of age and early exposure overlaps with critical periods of neurodevelopment and increased vulnerability to injury (age <12 years).1 Studies of age at first exposure have yielded conflicting results, with some suggesting exposure to head impacts at a younger age may increase the risk for negative long-term neurologic consequences2,3 and others finding that age at first exposure does not affect long-term brain health.4,5 In the short term, it is unclear how age at first exposure influences postconcussion recovery, limiting the clinician's ability to prognosticate and tailor postconcussion management on the basis of prior duration of exposure.
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See page 958
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