Statistics reveal that 250-350 people in a population of 250,000 suffer a head injury every year. Most of these will be in the mild category (ie concussion) but can often leave individuals feeling confused and frustrated due to difficulties they may experience. Symptoms can include cognitive problems such as headache, difficulty thinking, memory problems, attention deficits and mood swings.
There are often Instances in the news of rugby players experiencing concussive injuries and continuing to play their current game. The opening rounds of the Six Nations and game between Wales and England earlier this year brought this topic to light once again.
George North remained on the field for the entire match after two clear impacts he took to the head. One of which where he momentarily lost consciousness. The decision for him to be able to continue to play received strong criticism and many people took to social media to voice their opinion. George North had already suffered a concussive injury last autumn where he had to take a week of rest and was unable to play the sport.
World Rugby guidelines state any player who is even suspected of losing consciousness should immediately be removed from play, but there are many instances where this does not happen. In the case of George North, the incident was assumedly missed by the medical team, who did not have access to video play. The aftermath of the incident did result in the medical team managing George North in accordance to their guidelines on concussion. He was subject to a graduated return to play protocol with multiple follow-up cognitive tests.
For a player with concussion the consequences of being left on the field are considerable, especially with the risk of more significant injury. Outcomes after a single incident of concussion are often good. Evidence suggests in most cases after a neuro-physiological reaction, the brain can recover within a few days, or at most, a few months with no longer term issues. However, in some cases, such as repeated concussion, the outcome is less positive with reported ongoing problems. These can include cognitive weakness (for example poor concentration, decreased ability to process new information and memory difficulties.) The symptoms can be hard to explain and medical staff and professional coaches are often left unable to guide the individual.
Neuropsychologists often lead the assessment and rehabilitation guidance of individuals with concussion to ensure the individual can return to optimal, pre-injury levels of functioning. Input from a Neuropsychologist who understands the impact of concussive injuries on the brain can prevent further damage and potentially serious consequences. Input will often involve assessment and treatment. Quite often this can just be advice on rest and when the individual can safely return to work or normal routines. In some instances, rehabilitation may require practice of memory, reasoning and other cognitive skills to retrain the brain.
The topic of concussion in high impact sport is a serious one that requires proper attention. Statistics have emerged that former American footballers exposed to repeated head injuries were 19 times more likely to suffer serious long-term neurological problems than the wider population.