A CTE researcher and the bereaved father of Second Impact Syndrome victim, Ben Robinson, respond to concussion scepticism.
A CTE researcher and the bereaved father of Second Impact Syndrome victim, Ben Robinson, speak out on Dr Jim Andrikopoulos' concussion scepticism.
Dr Andrikopoulos' statements – claiming the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE), described by Stewart and a group of Boston researchers did not exist, and that the death of Robinson was an example of the risk inherent in sports like rugby – sparked controversy among researchers and readers across social media.
In particular, Dr Stewart, a consultant neuropathologist at Glasgow's Southern General Hospital, and the man responsible for diagnosing the first case of CTE in a deceased amateur rugby player, felt the need to clarify his concerns.
“What Dr Andrikopoulos illustrates is that everyone is entitled to an opinion, and at this stage, there is so much we don't understand about the long-term problems with concussion; there is scope for polarised opinion, not all of it terribly well informed,” acknowledges Stewart – a sentiment echoed by the IRB, who are keen to stress the “constantly evolving” nature of the science.
“But the view opinion that CTE doesn't exist – that just doesn't hold up.
“Believe it or not, those of us researching CTE are desperately trying to prove ourselves wrong and provide evidence head injuries are not linked to dementia.
“If I can construct or generate data from the study we're doing to say that actually, there is no problem – that's really the goal.
“Unfortunately all the data, everything that's coming through from North America, from Australia, from New Zealand, from our own work and from pathology studies around the world suggests there is a problem. We've yet to come across any data which definitively says there isn't.”
Stewart concedes that the true extent of rugby's CTE problem is impossible to predict – the research is in its infancy and the case numbers are very small – and is desperate to study as many individuals as possible.
“There isn't really an answer to what the risk might be because we don't have enough information,” he states.
“But as these various stories have raised awareness of the issue over the past few months, I'm hearing of more and more people who have experienced of dementia in ex-rugby and football players.”
Robinson's tragic death aged 14 was the upshot of a combination of failings that saw him thrice sustain head knocks without being removed from play.
His father, Peter, was left “speechless” by Andrikopoulos' comments.
“Ben died of mismanaged concussion,” said Robinson.
“For him to state Ben's case as if it were almost part of the game, that was the most hurtful thing. It's just an ill-informed comment to make.
“The autopsy showed Ben was hit in the head three times within the same time frame.
“Personally, I don't like the term Second Impact Syndrome, because people then say, 'it's rare'. It's a result of mismanaged concussion, a kid allowed to stay on.
“Ben's death was preventable.”
“What rugby is doing is sensible: whilst gathering the much needed evidence to base future management on, assuming the worst case scenario, that every kid who gets a bang on the head might get Second Impact Syndrome, that anyone who plays rugby for a number of years might develop dementia, and taking no chances,” adds Stewart.
“That's not hysteria, that's just perfectly sensible public health and pragmatism.”