Dr. Hofmeyr Viljoen Emphasizes the Importance of Head Injury Awareness as School Rugby Season Kicks Off

Johannesburg – As the rugby season commences in schools throughout South Africa, Dr. Hofmeyr Viljoen, a radiologist at SCP Radiology, is emphasizing the importance of understanding head injuries.

Injuries are a regrettable but common aspect of many sports.

Dr. Viljoen cautions that rugby, being a contact sport, inherently involves the risk of head injuries, which can range from mild concussions to severe Traumatic Brain Injuries (TBIs).

Importance of Early Detection

Detecting head injuries early is crucial for effective treatment and minimizing the risk of further complications.

In many instances, concussion or TBI symptoms might not be obvious right away, leading athletes to continue playing, which can exacerbate the damage.

Proper diagnosis and management of head injuries require both clinical evaluations and advanced imaging techniques.

Dr. Viljoen discussed the nature of these injuries, the vital role of radiology in their diagnosis and management, as well as preventative strategies.

Understanding Head Injuries in Rugby

According to Dr. Viljoen, several types of head injuries are prevalent in rugby.

“Concussion is the most common type, representing a mild traumatic brain injury that occurs when the brain is jostled inside the skull due to impact or rapid movement,” Dr. Viljoen noted.

“While some concussions may be mild, others can lead to significant short-term and long-term complications.

“In more severe cases, we observe skull fractures, contusions, and bleeding around the brain, all of which require immediate diagnosis and treatment.”

Recognizing the Symptoms

Dr. Viljoen highlighted the importance of recognizing concussion symptoms, such as headaches, dizziness, nausea, confusion, memory issues, light sensitivity, and trouble concentrating.

“Immediate recognition is crucial,” he explained. “Any player exhibiting these symptoms should be removed from the game to prevent further injury.”

The Role of Radiology

Radiology is essential for accurately diagnosing the severity of head injuries.

Dr. Viljoen stated that Computed Tomography (CT) scans are typically the first imaging method used in emergencies.

Although patients with concussions often do not show significant imaging findings, it’s vital to image those with severe concussions or unusual symptoms.

“CT scans quickly identify serious problems like fractures, brain swelling, and bleeding, offering crucial information for urgent treatment,” Dr. Viljoen said.

Magnetic Resonance Imaging (MRI) is utilized for more detailed assessments, particularly when concussion symptoms persist or worsen.

“MRI is excellent for detecting subtle injuries like microbleeds and brain swelling that CT scans might miss,” Dr. Viljoen mentioned. “Furthermore, MRI does not involve radiation, making it a safer option for ongoing assessments.”

Advanced Imaging Methods

New imaging technologies, such as Diffusion Tensor Imaging (DTI), hold promise for a better understanding and management of head injuries, particularly the subtle impacts of concussions.

“DTI can help identify damage to the brain’s white matter, potentially informing return-to-play decisions and treatment plans,” Dr. Viljoen stated.

Understanding Possible Complications – Second Impact Syndrome (SIS)

SIS is a rare but extremely serious condition that occurs when an individual suffers a second concussion before fully recovering from a prior one.

This secondary injury can be minor yet leads to rapid and severe brain swelling (cerebral edema).

Following the initial concussion, the brain struggles to regulate blood flow and pressure, making it susceptible to catastrophic swelling after another impact.

Symptoms can escalate quickly, often within minutes, and may include loss of consciousness, severe headaches, dilated pupils, respiratory failure, or even death.

Young athletes are particularly at risk for SIS. Due to its rapid onset and severity, SIS is classified as a medical emergency that demands immediate attention.

Preventing SIS requires strict adherence to concussion management protocols, ensuring complete recovery from any head injury, and closely monitoring symptoms before returning to sports or high-risk activities.

Addressing Chronic Traumatic Encephalopathy (CTE)

Dr. Viljoen noted that CTE is a long-term degenerative brain condition associated with repeated head traumas.

“CTE is particularly challenging because it can only be definitively diagnosed post-mortem,” Dr. Viljoen remarked. “However, ongoing research is striving to create methods to detect CTE in living patients, potentially using advanced imaging techniques like Positron Emission Tomography (PET).”

Most studies focus on developing non-invasive techniques to monitor brain conditions in living individuals over time.

Common Causes of Head Injuries in Rugby

• The high-impact nature of the sport primarily contributes to these injuries, with tackling identified as a significant risk factor. Poorly executed tackles or tackles at dangerous angles frequently result in head trauma, especially in young players whose tackling techniques may still be developing. Educating young players on correct tackling strategies early can mitigate these risks.
• The dynamic nature of rugby can lead to players being knocked down forcefully or falling awkwardly. Even with protective gear, an impact with the ground can lead to concussions or more severe injuries.
• Speed and intensity in the game often result in unintentional collisions between players. These can include head clashes and impacts from knees or elbows, resulting in injuries from mild concussions to more severe brain injuries. Implementing preventative measures and promoting safer playing practices can help reduce these risks.

Prevention Remains Critical

Dr. Viljoen emphasizes the significance of proper training: “Educating young players on safe tackling methods and enforcing protective guidelines can greatly lower injury risks.

“While equipment like head guards can lessen surface injuries, they do not prevent concussions.”

He also advocates for strict adherence to concussion management protocols.

“Coaches at schools and clubs must consistently apply concussion strategies, ensuring players are properly evaluated and cleared by medical professionals before returning to play,” Dr. Viljoen urged.

Under-reporting in schoolboy rugby is common, as players may wish to continue playing or may not recognize concussion symptoms.

“Rugby is an excellent sport for fostering teamwork and resilience, but player safety must always take precedence,” Dr. Viljoen concluded.

“By promoting awareness, ensuring timely medical intervention, and implementing proper prevention strategies, we can significantly reduce the occurrence and severity of head injuries, allowing young athletes to safely enjoy the sport they are passionate about.”