• history
• neurology

“A young man playing at cudgels in Moorfields received a stroke on his forehead; it did not seem to himself to be a particular severe one, but as it produced blood it was deemed by the laws of the game to be a broken head, and he was obliged to yield to his antagonist . . .as it gave him no trouble, he took no notice of it and was for several nights afterward engaged in the same diversion which followed his daily labour...on the ninth day from that on which he received the blow, he thought that his forehead was somewhat swollen and felt tender to touch . . .the swelling and pain increased and he found himself much out of order . . .an incision was made into the tumour . . .a circular piece of the scalp was removed which discovered a fracture . . .a trephine was passed into the fracture line and the bone was removed . . ..the dura mater was found discoloured and beginning to have matter on its surface . . .he was let blood . . .until his pulse failed . . .by proper care he was brought to himself . . .it is very clear that unless the cranium had been perforated he must have perished” (Case XVIII)¹

This case report, published in 1768 by Percivall Pott, represents the first example in the medical literature of sports neurology. Now popularised by current day neurologists and neurosurgeons such as Jordan and Cantu, sports neurology has slowly evolved into a distinct subspecialty of neurology.^2–6

The case report described above also illustrates a number of other features. It is the first demonstration of the “blood rule” in action and serves to graphically illustrate the perilous nature of head injuries …