• Haruhiko Sato, Ko Sasaki, Akihiko Nakamura, Fusao Nakamura, Mutsuo Yamada, Akira Maeda, Arihisa Fujimaki, and Ichiro Watanabe.
• Department of Neurosurgery, Seirei Mikatahara General Hospital, Shizuoka, Japan. Electronic address: jojosato@sis.seirei.or.jp.
• World Neurosurg. 2021 Aug 1; 152: e112-e117.

ObjectivesAcute subdural hematoma (ASDH) is known to be devasting sport-related head injury but it is relatively rare in rugby compared with other contact sports. Certain cases of ASDH have happened in high school rugby players in Japan. To prevent them from the injury we report a background of the players.MethodsData of high school rugby players who suffered ASDH were extracted from injury reports in the Japan Rugby Football Union between April 2004 and March 2020. The number of injured players, diagnosis on the report, school year, phase of play where the injury occurred, and playing career were analyzed.ResultsThere were 30 cases of ASDH including 16 cases in the first year, 9 in the second year, and 5 in the third year of playing. Phase of play was mainly being tackled in 11 (37%), and tackling in 13 (43%). Novice players, defined as a player having less playing experience of rugby during junior high school, accounted for 77% of phase of tackling, 82% of being tackled. First year novice players accounted for 100% of phase of being tackled. Outcome within 6 months after injury was recovery in 14, morbidity in 6, mortality in 2, and unknown in 8.ConclusionsPlaying experience in high school rugby players should be considered as an important factor for prevention of ASDH-in particular, phase of being tackled is riskier than that of tackling for first year novice players.Copyright © 2021 Elsevier Inc. All rights reserved.

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