Objectives To systematically analyze potential head injuries in professional international women's football between 2021 and 2024. Design Video analysis. Methods All match footage from the 2021 Women's Olympic Football Tournament, 2022 Union of European Football Associations European Women's Championship, 2023 Fédération Internationale de Football Association Women's World Cup, and 2024 Women's Olympic Football Tournament was reviewed. Potential head injuries, defined as when a player stayed down on the ground for more than 5s and/or indicated that they were injured, with the body area involving the head, were coded using frame-by-frame video analysis to record player actions, visible signs of possible concussion, medical assessment, and injury outcomes. Results Across 147 matches, 362 potential head injuries occurred (2.46 per match; 72.2/1000 match hours). In total, 131 potential head injuries (36.2%) were medically assessed, and 12 (3.3%) resulted in immediate substitution. Visible signs of a possible concussion were seen in 84 players (23.2%), with motor incoordination present in 10 cases (2.8%). Medical assessment was performed in 61 (72.6%) of cases with visible signs. The majority of potential head injuries (n=251, 69.3%) were from opponent direct contact, followed by ball-related contacts (n=48, 13.3%, 35 unintentional ball-to-head impact, and 13 headers). Aerial duels (45%) were the most common action leading to a potential head injury. Conclusions Opponent direct contact was the most frequently observed mechanism of a potential head injury. While the majority of players with visible signs of possible concussion received medical assessment, continued concussion awareness to support medical teams in improving the identification of incidents with potential head injuries is recommended, with a potential for the inclusion of visible signs of a possible concussion to facilitate an on-field medical assessment of players.
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