Concussion issue big enough but now research links big hits with Alzheimer’s
Brain injuries expert’s published case on early onset dementia caused by rugby could effect management of head injuries
Brian O’Driscoll went back on the pitch during the Six Nations game against France last season despite having stitches to a wound in his ear, suffering a dead leg and reportedly after a concussion. Photograph: Colm O’Neill/Inpho
Australian flanker George Smith is helped of after a severe head clash with hooker Richard Hibbard early in the third Test against the Lions. Smith was back playing five minutes or so later. Photograph: William West/AFP/Getty Images
Ireland’s Six Nations match against France in March of this year was compelling and curious in a number of ways, not least of all that the paths of Brian O’Driscoll and Luke Marshall crossed in the medical room as well as on the pitch.
Marshall suffered concussion, while O’Driscoll had stitches to a wound in his ear, suffered a dead leg and was also reportedly concussed.
He was bowled over by French prop Vincent Debaty and left the field before returning for the final four minutes.
Following the match Ireland winger Keith Earls enthused: “When you see a fella who doesn’t know where he is one minute and comes back on with his head all strapped up; he’s a true warrior,” said Earls. No question.
In the final Six Nations match against Italy, Marshall clashed heads with outhalf Paddy Jackson and was again forced out of the game.
Three weeks later the centre returned for Ulster’s Heineken Cup quarter-final with Saracens. He was concussed once more and subsequently ruled out for the rest of the season and not considered for Ireland’s tour to North America.
Concussion, like other issues such as drugs in sport and HawkEye, may be suffering from fatigue syndrome.
Rugby knows it’s there. They do the best they can. It’s part of contact sports and the best medical practices are followed. The IRFU, the Irish provinces and the International Rugby Board reiterate this time and again and last year the IRB council introduced guidelines on diagnosis, care and return-to-play protocols.
But the gravity of the problem was ramped up earlier this month when clinical research released by Dr Willie Stewart, consultant neuropathologist in Glasgow’s Southern General Hospital, made public what he believes to be the first confirmed case of early onset dementia caused by playing rugby.
A former player, Dr Stewart had believed for a long time there was a link but had no scientific proof. Then one day his phone rang.
“I’ve said for several years now that from what we know about American football and boxing there is absolutely no reason at all to expect rugby is immune from this disease unless they are saying that people who play rugby have a completely different brain to the rest of us,” says Dr Stewart.
“When a potential case came along my colleague was very quick to pick up the phone and call me to come and look at it.”
What he saw was a build up of abnormal proteins in brain cells, more normally connected to patients with Alzheimer’s disease. In this case, it was a deceased male in his 50s and the only link to head injury was through playing rugby.
Until the last decade, this pathology was thought only to be present in boxers. But the focus has latterly shifted to other contact sports.
“It’s the first link,” says Dr Stewart. “Colleagues of mine in Boston have looked at a youngster who played rugby but that youngster also played American football and so how much could we say?