title: Craniofacial injuries in professional cricket: no more a red herring.
abstract: The issue of head injury in a noncontact sport like cricket is a matter of great debate and it carries more questions than answers. Recent incidents of fatal head injuries in individuals wearing a helmet have caused some to question the protective value of the helmet. The authors discuss the pattern, type of injury, incidents, and location of cranio-facio-ocular injuries in professional cricket to date. They evaluate the history of usage of the helmet in cricket, changes in design, and the protective value, and they compare the efficacy of various sports' helmets with injury profiles similar to those in cricket. The drop test and air cannon test are compared for impact energy attenuation performance of cricket helmets. A total of 36 cases of head injuries were identified, of which 5 (14%) were fatal and 9 (22%) were career-terminating events. Batsmen are the most vulnerable to injury, bearing 86% of the burden, followed by wicketkeepers (8%) and fielders (5.5%). In 53% of cases, the ball directly hit the head, while in 19.5% of cases the ball entered the gap between the peak and the faceguard. Ocular injuries to 3 wicketkeepers proved to be career-terminating injuries. The air cannon test is a better test for evaluating cricket helmets than the drop test. Craniofacial injuries are more common than popularly believed. There is an urgent need to improve the efficacy and compliance of protective restraints in cricket. A strict injury surveillance system with universal acceptance is needed to identify the burden of injuries and modes for their prevention.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Manjul
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Dhaval P
authors.initials: DP
authors.lastname: Shukla
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Dhananjaya Ishwar
authors.initials: DI
authors.lastname: Bhat
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Indira Devi
authors.initials: ID
authors.lastname: Bhagavatula
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
authors.forename: Tejesh
authors.initials: T
authors.lastname: Mishra
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D001930:Brain Injuries / Q000517:prevention & control*; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000517:prevention & control*; D004867:Equipment Design; D017408:Guidelines as Topic; D006260:Head Protective Devices; D006801:Humans
keywords: ICC = International Cricket Council; ball; batsman; concussion; cricket; head injury; helmet; protective gears