Treating head injury

SIR – Any athlete who sustains a head injury (“Brain-injury experts ‘alarmed’ by delay to Karius diagnosis”, Sport, June 6) should immediately be removed from the field of play for an in-depth examination.

In 1971, while I was working in neurology at St James’s Hospital in Leeds, a professor of Ancient Greek was admitted because he appeared to his colleagues to be in a confused state – specifically, he was unable to name any of the Ancient Greek poets.

It turned out that he had struck his head while alighting from a taxi two days earlier. He had staggered in to university in a slightly dazed state, but brushed aside offers of help. While he had not lost consciousness, he became more confused and unable to lecture.

An operation revealed a large, fluid-filled cyst pressing on his brain beneath the part of his skull which had collided with the taxicab door lintel. It was removed and he recovered.

Goalkeeper Loris Karius, and others suffering a similar injury, should submit to further neurological examination whether they have symptoms or not. Cysts frequently develop slowly, so symptoms may not show for several days.

Dr Trevor G Plunkett

Norwich