This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. Rugby is a popular sport in South Africa (SA), played by children from as young as seven years of age. [1] Rugby is classified as a high-impact and collision sport, which adds to its high potential for contact injury, such as mild traumatic brain injury (mTBI). [2] Young players are particularly vulnerable to sustaining mTBI, as the brain is not yet fully matured and therefore more vulnerable to the effects of the damage associated with brain injury. [3] The prevalence of mTBI in schoolboy rugby players has been cited to be as high as 50%. [4] Many of these injuries are often unrecognised and unreported as players may be likely to underreport symptoms to expedite return to play. [5] Research indicates that the younger brain is particularly vulnerable to short-and long-term effects of concussion and requires longer recovery time from symptoms, as the brain is not yet fully developed. [6] Impulse control and selfmonitoring of behaviour are particularly susceptible to the effects of concussion during this developmental stage. [7] While relatively few studies have been undertaken on the length of time for symptom recovery among rugby players, existing literature demonstrates that, in most cases, it is presumed that symptoms dissipate within 3-10 days. [8,9] However, children and adolescents may take longer to recover. [10] Symptoms that occur within three months of the incident are considered to be 'acute'; when persisting in excess of three months, symptoms are deemed to be 'chronic'. [11] Findings by De Kruijk et al. [12] revealed that 28% of players had not fully recovered six months post mTBI and were therefore considered to have 'chronic' symptoms. A small minority of individuals may experience effects from six months until three years post mTBI. [13,14] The effects of moderate to severe mTBI can be permanent, and one of the most feared long-term effects is dementia. [15,16] Neuropsychological functional impairments following mTBI include a variety of symptoms which may significantly affect physical, cognitive and emotional well-being. [17-21] Table 1 portrays these symptoms, of which headache, fatigue, drowsiness, nausea and sleep disturbances are among the most commonly reported symptoms following mTBI. Physical symptoms indicative of cranial nerve damage include nausea, dizziness, blurred vision, diplopia, sensitivity to light and noise, hearing loss, tinnitus, and diminished sense of taste or smell. [22,23] Cognitive symptoms include attention and concentration difficulties, confusion and feeling mentally 'foggy'. [24] Behavioural and emotional symptoms include apathy and affective disturbances such as agitation, aggression, anxiety, depression, irritability and feeling more emotional. [25] More severe injuries are regarded as 'red-flag' signs, and a longer recovery period is suggested. [17-21] Table 2 outlines the recognised red-flag signs indicating emergency situations which necessitate referral to an emergency unit. The ...
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