Following the severe accident at Indianapolis, where he went backwards into the wall at high speed, there is conjecture about whether Ralf Schumacher will drive at Magny Cours on July 4. It is my medical opinion that there should be no conjecture. He will not drive at Magny Cours, and could miss more GPs.

Whilst Prof. Watkins is the medical referee, there are many tell tale signs to show that Ralf has indeed suffered a severe insult to his brain. "I had a severe concussion" admits Ralf. "I just want to go home. I want to go to my wife and son," showing irritability, another classic symptom of the concussive syndrome.

Concussion is bruising to the brain, and like a 'corked' leg, well known to footballers, the situation in the brain is similar. The difference is that concussion has the potential to be mentally debilitating. Corked legs are an inconvenience.

Ralf has also indicated that he has no real memory of the race, other than the start. This again shows a severe concussion, giving rise to a condition known as post-traumatic amnesia. As you function, everything you have just experienced is recorded in 'memory' by the brain, just like hitting the 'save' button on the computer. If something happens to interrupt the process, it doesn't get 'saved'. The more severe that "something" is, the further back goes the loss of memory.

Unless there is frank bleeding inside the skull, there is no operative intervention needed, and the treatment is to allow the body's natural reparative function to occur. This takes time, measured in weeks, not days.

If he were my patient he would not be driving a race car for at least six weeks and then only after a thorough neurological review. Looking at the telecast, I believe that he was initially completely stunned, as it appeared to be quite some time before he began to move. Having had a previous similar injury, this is potentially very serious. It takes time for any bruise to resolve. The brain is no different. To expect full recovery in two weeks is overly optimistic.

In these impacts, the crash helmet cannot protect the brain inside the skull. The brain floats in fluid, and in the sudden stop, the brain continues in its motion, 'crashing' into the inside of the now stationary skull. It is this 'secondary' impact that causes the traumatic bruising to the brain.

Dr Iain Corness
Pitpass Medical Delegate