title: Head injuries in full contact karate competition! Is the prejudice in management minimising the required investigation?
abstract: A 33 year old male karate practitioner presented himself for a full-contact national karate competition. This individual competed for approximately 2 minutes and received a kick to the head. He collapsed in the competitive arena, and suffered a tonic-clonic seizure, lasting for 3 minutes 25 seconds. Examination in the competitive arena revealed an individual who was unconscious. First aid, and paramedic support was provided immediately. Medical assessment identified the presence of vital signs. Glasgow coma scale (GCS), post trauma was recorded as 3/15 until the fifth minute. A patent airway was established and a neck brace was applied. Blood pressure within 1 minute of trauma was 195/98 mm.Hg, heart rate was 185 bpm and respiratory rate was 40 breaths·min(-1). Oxygen was administered via a ventimask. The patient was conveyed to the medical area. The patient regained consciousness one minute after the seizure had resolved, but had amnesia concerning the event. GCS at five minutes was recorded as 13/15. The patient was transferred by ambulance to the nearest Hospital. The patient was discharged, following examination without further investigation. The finding of this study suggests that an individual with a history of head injury should have received computerised tomography as a minimum investigation. This may help eleviate the risk of further medical complications. Key pointsHead injuries are common in full contact sports.GCS is the examination of choice to determine neurological status in the field.Detailed neurological examination cannot detect intra-cerebral haemorrhage.38% of mild brain injuries result in intra-cerebral haemorrhage.Discussion between clinicians in the field and hospital clinicians is necessary to provide full details of the clinical picture to avoid premature discharge.
authors.affiliation: Health and Exercise Science Research Laboratory, School of Applied Sciences, University of Glamorgan , Pontypridd, Wales, CF37 1DL, UK.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Graham
authors.forename: Bruce
authors.initials: B
authors.lastname: Davies
authors.forename: Julien S
authors.initials: JS
authors.lastname: Baker
keywords: Cerebral trauma; computerised tomography; mild head injury; prevention