What is a Concussion?
Navigating the Impact: Understanding Concussions and Prioritizing Recovery
What is a concussion?
Concussions, or mild traumatic brain injuries, are when we experience either a direct or indirect blow to the head that causes injury. This can also be due to acceleration/deceleration (such as whiplash). The main causes of concussion are car accidents, assault, being struck by an object, and participation in recreational sports.
Who gets concussions?
Most of our understanding on concussions comes out of research in recreational sports and military injuries. Often athletes in contact sports experience concussions, but even those in non-contact sports like volleyball can experience them. Concussion rates in women are also rising, though this may be due to an improvement in diagnosing and recongizing concussions.
What sports have the highest incident of concussion?
Football accounts for the highest percentage of sport related concussions in men, whereas soccer (and sometimes basketball) accounts for the highest percentage of concussions for female athletes. Women experience concussions twice as often as men playing the same sport despite participation with the same rules. We aren’t entirely clear why this occurs, or why women tend to experience more intense symptoms for longer.
What happens when I get a concussion?
We still don’t full understand what happens when a concussion occurs. However we do know it is likely due to a combination of changes in brain chemistry and metabolism following the injury rather than a physical or structural change to the brain.
Some of these cellular changes may be due to injury to the axons (the pathways that transmit signals in our brain), changes to how our brain uses blood sugar, changes in blood flow, changes in electrolytes balance in the brain, inflammation. and alterations to cell metabolism.
We think that when the trauma occurs, the cells start to use up energy in chemical reactions. Eventually this leads to a lack of energy available or energy-deficit in the brain. We think this state can lead some of the symptoms we experience after a concussion such as to mood changes, brain fog, and headaches.
What are the symptoms I might feel after a concussion?
The symptoms post concussion may range from emotional, physical, cognitive and symptoms that impact sleep.
Changes in mood
Irritability
Confusions
Memory troubles
Brain fog
Trouble concentrating
Headaches
Dizziness
Balance challenges
Visual disturbances
Drowsiness
Sleeping less or more
Having trouble sleeping
What should I do if I have a concussion?
Concussions should be evaluated by health care provider, and patient with severe head injury symptoms should be monitored by hospital.
Athletes should be removed from participating in games after sustaining concussions. Rest from both physical and cognitive activity should occurs for the first few days following (24 to 48 hours post injury).
However extended rest that use to be recommended (dark room for days) is no longer the standard of care. After this initial 24 to 48 hours of rest, we want to people moving and thinking gradually again. If symptoms return, rest should start again until the symptoms improve.
We are still learning a lot about concussions and how to navigate the support, including how to stage gradual return to activity. Currently, having the patient listen to their body and symptoms and gauging tolerance to activity and light movement is our best bet.
How long does recovery take?
Most people recover fully from a concussion within a month, sometimes as short as 1-2 weeks. In certain cases, patients may experience Post Concussion Syndrome (PCS) in which patients experience symptoms that persist for months after the initial injury.
How do I prevent concussion?
Concussion prevention starts with leveraging anything we can to protect our heads. This includes the basic safety measure like using a seat belt in cars, wearing a helmet, and doing what we can to prevent falls. Sport specific prevention includes using proper technique when heading the ball in soccer, and wearing protective equipment in contact sports. More research is coming out about the role that neck strengthening may play in preventing concussions. For individuals that have experienced multiple concussions and continue to participate in sport, education, monitoring and intentional supplementation may make sense.
What else should I know?
There may be a role for further investigation and support in those who have had a concussion and are struggling with their fertility. This is due to the hormonal disruptions that can occur after experiencing a concussion.
Patients continuing to experience symptoms beyond a month after injury should seek additional support from their health care providers to investigate options for treating their potential post-concussion syndrome.