Traumatic Brain Injury

Mike Brown severely concussed in rugby match

on Posted in Australia.

Mike Brown severely concussed in rugby match

The Sydney Morning Herald

Paul Hayward

February15,2015

No ordinary concussion: Mike Brown of England is knocked out after clash with Andrea Masi .

No ordinary concussion: Mike Brown of England is knocked out after clash with Andrea Masi . Photo: Getty Images

Small mercy. At least this time there was no chance of Mike Brown carrying on, as George North had after being knocked out in Cardiff last Friday.

There was no debating the correct next step after the England fullback was rendered unconscious by a collision that fully merited the old label: "sickening". After the week rugby has had, with concussion discussions everywhere, the last thing England's second Six Nations fixture wanted was an accidental blow to the head so forceful that it left the victim face down and motionless on the turf.

The really bad KOs in sport are when the struck player lies as if in a deep night-time sleep. That was Brown's serene state after Kelly Haimona had chipped ahead, Andrea Messi chased it and the England No.15's jaw came into full body-paralysing contact with the Italian centre's shoulder.

Brown lies motionless after the collision.

Brown lies motionless after the collision. Photo: Getty Images

The focus in this 47-17 victory will fall on Jonathan Joseph's brilliant attacking play and the try scored by the prodigal Danny Cipriani with his second touch of the match as a second-half substitute. But even Joseph's redeployment to the wing was traceable to Brown's horrible mishap, which prompted Stuart Lancaster, the head coach, to move Anthony Watson to full-back and Joseph out wide.

Brown, remember, is the steam train of this England side. He was the Six Nations player of the championship last season and exudes a certain aggression and toughness. In Cardiff last Friday night it was Brown loudly asserting England's right not to stand in the cold while Wales delayed their tunnel walk. This time, though, he was not the steam train but the buffers.

This was not concussion in the way we normally speak of it. This was lights out. In boxing parlance Brown was sparko. As the first England medical staff galloped towards the patient you knew many others would follow. Sure enough, a dozen figures were soon gathering round the fallen fullback, with a motorised cart by their side. Brown's head was stabilised and an oxygen mask applied. After a delay of eight minutes - the game was only 13 minutes old - the Harlequins man was finally strapped to a stretcher and driven off the pitch, not moving, but talking, by all accounts, to medics.

Brown receives medical attention.

Brown receives medical attention. Photo: Getty Images

Brown was not the only player in this match to need medical attention for a bang to the skull. Italy's Francesco Minto was also removed for a head injury assessment but returned. So did Brown - to the spectator seats, at least. Fifty minutes into the game, with England pulling clear, a roar went up around Twickenham as a tracksuited Brown came gingerly up the tunnel to watch the rest of the match. This is not in any way to question the judgment of doctors, but was it necessary to parade him before an 80,000 crowd like an unvanquished gladiator? Would he not have been better staying somewhere quiet?

So all was well? You would hope so, but the way England handle Brown's case now will be a vital test of their willingness to back up recent concern about concussion by not rushing their first-choice fullback into action.

"We'll take him through the return-to-play protocol," Lancaster said. "We looked at him in the changing room and he seemed fine. He was a bit grumpy to miss the game." The neutral hope must be that he watches the whole of the Ireland game in Dublin from the sidelines.

Brown returned to the bench in the second-half.

Brown returned to the bench in the second-half. Photo: AFP

We learnt during the week that the number of reported concussions in English rugby rose 59 per cent in 2013-14 compared to the previous season: partly because players appear more willing to report symptoms, but also as a consequence of rugby becoming more muscle bound and big-hit obsessed.

"There is greater awareness by players as to what their symptoms mean and a willingness to declare those symptoms to club doctors," Dr Simon Kemp, the Rugby Football Union's chief medical officer, said.

The sport generally however still has a leg in both camps. On one side there is a growing acceptance that a whiff of smelling salts and a "get back out there" attitude belongs in a vanished era. At the same time Warren Gatland, the Wales coach, still feels able to make jokes about North's "hard head" after a clash with his own teammate Richard Hibbard had knocked North out. As several commentators noted, much of the inquest was taken up with procedural issues to do with Wales's medical staff and what they had and had not seen, rather than North's injury and what the correct next step should be.

But then came those concussion stats, the first of three reports over the next two months, with attention falling, Kemp told the BBC on "the health of players once they retire". A study with Oxford University is looking at possible links between playing rugby and neurodegenerative disorders. At the World Cup this year, World Rugby is expected to provide replays for medical teams and an independent doctor at every match, which will remove any unspoken pressure on medics to keep recovery times to the minimum.

In the end Gatland decided North would not play against Scotland, whether he was symptom free or not. England's next fixture in this championship is Ireland in Dublin on March 1 - the pivotal fixture. The appropriate evidence is not any reassurances Brown might give - or the absence of obvious symptoms a week from now - but replays of the collision and the state he was in when shoulder struck head. As knockouts go, it was comparable to Carl Froch's right-hand to the jaw of George Groves at Wembley last year.

England have squadrons of players. By the time the World Cup gets here Joseph should be a sensation in his sport. Watson showed himself to be an able deputy at fullback. And Cipriani is back from the wilderness.

With all this manpower, England can afford to play safe with someone whose physical courage led him into rugby union's growing danger zone.

 

Traumatic Brain Injury

Traumatic brain injury (TBI) is an acquired brain injury (ABI) caused by physical damage to the brain, either as a result of a a blow to the head or by the brain impacting with the skull via a whiplash motion of the head. Bruising, bleeding, swelling, or tearing of brain tissue may occur. The head being forced to move rapidly forward or backward