What happens when concussion occurs?

In episode 17 of HCA UK’s ‘Health Fact vs Fiction,’ host Anna Richardson talks about the effects of concussion with Dr Richard Sylvester, consultant neurologist at the Institute of Sport Exercise & Health, part of HCA Healthcare UK, and former England rugby player, Kyran Bracken.

Special guest Kyran Bracken

For all its benefits, both socially and from a fitness-inducing perspective, there’s no denying the increased dangers of injury when participating in contact sports. This is certainly true of concussions, which as Kyran knows all too well are particularly common in sports such as rugby – where players’ heads coming together in the scrum are part and parcel of the game.

As Richard tells Anna, contrary to popular belief one doesn’t have to be “knocked out” out to be concussed. Indeed, if you do ever find yourself with someone experiencing dizziness or blurred vision after a bang on the head – it’s definitely wise to get them to a doctor sooner rather than later.

Things we learn in this concussion episode

We’re all likely to have bumped our heads at some point in our lives. Some of us will have experienced whiplash - and if you play a contact sport, your chances of experiencing concussion increase significantly. But do we really understand what’s happening inside our brains when a concussion occurs? Dr Richard Sylvester, consultant neurologist at the Institute of Sport Exercise & Health, part of HCA Healthcare UK, joins Anna, along with former England rugby player, Kyran Bracken. 

Concussion Fact

You don’t have to be knocked out to be concussed. In fact, Richard explains that around 90% of concussions are in people who haven’t lost consciousness. To spot a concussion you should be looking out for symptoms like dizziness, blurred vision, drowsiness or even being over emotional.

Cause of concussion Fiction

Concussions are only caused by a direct blow to the head. A concussion is actually caused by your brain moving rapidly in your skull so, as Richard tells us, a whiplash injury or even a hit to the chest can shake the brain and cause a concussion.

Recovery from concussion Fact

Recovering from a concussion takes time. 90% of people will feel completely normal after six weeks, whereas 10% of people will still feel the effects. Richard says that concussions can disrupt the brain’s balance system which requires specialist physiotherapy and rehabilitation.

Concussion symptom Fact 

A concussion and a bleed in the brain can appear the same in their symptoms. In rugby or other contact sports, if a player suffers a head injury then its important they come off the pitch immediately and are checked over. Kyran Bracken tells Anna about his experience of concussion as a player, and now as a coach of teenagers.

What to do next...

Dr Richard Sylvester

Dr Richard Sylvester is a Consultant Neurologist at HCA Healthcare UK’s Institute of Sport, Exercise and Health (ISEH) where he provides the neurology assessment and input for the concussion clinics.  Richard is also based at the National Hospital of Neurology and Neurosurgery and Homerton University Hospital.
Richard qualified from Oxford University and then went on to receive a doctorate in Cognitive Neuroscience from UCL.  His clinical interests include neurorehabilitation after traumatic brain injury and young onset cognitive disorders.  Richard also specialises in managing the acute and long-term effects of sports related concussion.

Richard is a member of the Association of British Neurologists traumatic brain injury advisory group and a founder and executive member of the UCL Partners Centre for Neurorehabilitation. Additionally, Richard is on the English Football Association’s expert concussion advisory panel and has been an independent concussion expert at the 2016 Rugby World Cup.


Kyran Bracken

Kyran Bracken MBE is a world-cup winning former rugby union player who played at scrumhalf for Saracens, Bristol and Waterloo.  Prior to this, Kyran studied Law at the University of Bristol and subsequently went on to qualify as a solicitor.  

Kyran made his England debut in November 1993 against the All Blacks and the went on to play in multiple Rugby World Cup matches. Throughout Kyran’s career, he won a total of 51 England caps and captained the team on three occasions.  Like many rugby players, Kyran has previously suffered with concussion multiple times, and at one stage was advised to retire as a result of it.  He retired from rugby in 2004.

Kyran is an Honorary President of the rugby charity, Wooden Spoon, which aims to improve the lives of disadvantaged and disabled children in Britain and Ireland through playing rugby.  He is also an Ambassador of the Royal National Children's Foundation (formerly the Joint Educational trust) which helps support vulnerable, disadvantaged young people at state and independent boarding schools throughout the UK.

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