Resident Doctor University College London Horsham, England, United Kingdom
Case Diagnosis: A 15-year-old female rugby player competing in the U16 category at a national school 7s tournament presented with headache, fatigue, and reduced concentration several hours after a suspected concussion. Symptoms developed following a head impact during a tackle in the first match of the day.
Case Description: The athlete sustained a head impact at approximately 10:00 during a tackle and reported an immediate dazed sensation but no loss of consciousness or vomiting. She continued playing the final minutes of that match. Afterwards, she experienced increasing sleepiness and took brief naps in between remaining matches but did not inform coaching staff or event medics. She participated in several additional matches throughout the day.
At 17:00, after the day's competition had concluded, the player presented to the medical tent with ongoing headache, fogginess and tiredness. Neurological examination was normal. Given the mechanism of injury and evolving symptoms, she was diagnosed with a sports-related concussion. She was removed from further participation in the tournament and provided with standard concussion advice, including immediate rest, red-flag symptom monitoring, and a staged return-to-play protocol. Her coach was informed and parental contact was arranged.
Discussions: Despite growing public and organisational awareness of concussion risk in youth sport, this case demonstrates persistent challenges in early symptom recognition, athlete self-reporting, and sideline identification. The athlete continued to compete for several hours despite progressive symptoms, and although some teammates had noticed her fatigue, her coach remained unaware. Factors likely contributing to delayed reporting include underrecognition of early symptoms, desire to continue playing, and limited communication between athlete and staff.
Conclusions: This case highlights an ongoing need for strengthened concussion education for young athletes and coaches, improved sideline monitoring procedures, and reinforcement of a "when in doubt, sit them out" approach in youth rugby to ensure timely concussion recognition and management.
