Princess Anne: Concussion is a risk so she must not rush back

The Princess Royal is definitely a minimum fuss sort of person – the kind of woman you’d have expected to want to go home to cook supper after her ‘incident’.

Yet she was admitted to hospital overnight for observation, which suggests this was more than just a minor knock.

At 73, Princess Anne is at an age when concussion becomes more of a risk, partly because of the greater risk of falls due to frailty – although this doesn’t seem to be the case for her – but also because the brain itself becomes more vulnerable generally.

Concussion occurs as a result of the brain being shaken around in the skull. The greatest danger is that a blood vessel is torn, causing bleeding on the brain.

It doesn’t even have to be a major knock to cause problems: a bag falling out of the overhead locker on a plane or a branch from a tree could be enough to cause a haemorrhage or bruising.

This can lead to swelling, which may then be followed by the symptoms of concussion – confusion, irritability, nausea and headache – which can last for some days.

Patients with suspected concussions should undergo an emergency CT scan to check for a fractured skull or internal bleeding.

Any patient with a concussion needs rest and supervision, as loss of balance and lack of coordination are not uncommon particularly in older patients (even when the scans haven’t shown any significant damage in the brain).

And the supervision may be ongoing.

I’ve seen several patients who have suffered increasing confusion and disorientation months later, with a brain scan showing a very small blood vessel slowly leaking following the original head injury.

This is more likely to happen in older patients who are regularly taking low-dose aspirin or similar medication.

Hopefully, the Princess Royal will make a rapid recovery from this accident but she does need a week or three to fully recover, so she must stand back from her diligent adherence to duty.

I am reassured to hear she will not now be attending a Buckingham Palace banquet for the Japanese state visit tonight and on doctors’ advice, she will no longer travel to Canada as was originally planned at the end of this week.

But she must be assiduous about not rushing back to work after this, too.