Princess Anne, 73, mustn’t rush again to duties, warns Dr Martin Scurr

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’.

And 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.

Princess Anne is at an age where concussion becomes a greater risk, both because of the greater risk of falls but also as the brain becomes more vulnerable, writes DR MARTIN SCURR

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 concussion should undergo an emergency CT scan to check for a fractured skull or internal bleeding.

Any patient with concussion needs rest and supervision, as loss of balance and lack of coordination are not uncommon but 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.

The fact that the Princess Royal was admitted to hospital overnight for observation suggests this was more than just a minor shock

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, and 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.