title: An unusual presentation of a minor head injury sustained during a game of rugby.
abstract: In the UK, about 2% of the population attend the accident and emergency (A&E) department every year after a head injury. A majority of the patients have minor head injury and are discharged. Studies reveal that patients who reattend the A&E after a minor head injury represent a high-risk group. Concussion injuries are common and not all require treatment at the time of presentation. However, some may worsen after initial presentation and develop signs of serious head injury. A case of minor head injury as a result of head butt during a game of rugby, not associated with alteration in conscious state or focal neurological signs, and subsequent development of frontal lobe abscess a month later is reported. It is important that patients fit to be discharged at the time of consultation are discharged in the care of a responsible adult with clear head injury instruction sheets and are advised to return should their symptoms change. A high index of suspicion should be maintained and an early imaging technique, such as CT scan should be considered in patients reattending the A&E with persistent symptoms even after minor head injury.
authors.affiliation: James Paget University Hospital, NHS Foundation Trust, Great Yarmouth, Norfolk NR31 6LA, UK. kathmanducity@aol.com
authors.forename: Debesh
authors.initials: D
authors.lastname: Rimal
authors.forename: Sonu R
authors.initials: SR
authors.lastname: Thapa
authors.forename: Namal
authors.initials: N
authors.lastname: Munasinghe
authors.forename: Mark
authors.initials: M
authors.lastname: Errington
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000209:etiology*; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology; D004630:Emergencies; D005538:Football / Q000293:injuries*; D006801:Humans; D008297:Male; D011859:Radiography; D013290:Streptococcal Infections / Q000209:etiology*; D034364:Streptococcus milleri Group / Q000302:isolation & purification