Concussions
In simple terms it is a brain injury sustained by a blow
either to the head or to the body resulting in traumatic forces being applied
to the brain. It is not a “bruise” to the brain, but rather a trauma.
Some head injuries may appear to be mild but research is
finding that concussions can have serious, long-term effects, especially repeat
head injuries or cumulative concussions. A concussion is typically caused by a
severe head trauma during which the brain moves violently within the skull. The
brain cells all fire at once, much like a seizure. Some studies show that
patients who suffer a concussion appear to have the brain activity of people in
a coma.
A concussion may result from a fall in which the head
strikes against an object or a moving object strikes the head. A suddenly
induced turning movement such as a blow that twists the head (like a punch to
the side of the face) is more likely to produce unconsciousness.
In the immediate aftermath of a concussion, there may be
some structural damage which causes cell death.
However, the primary problem is a chemical one in the cells that have
survived the trauma.
When there is a sufficient blow to the brain, the membranes
of the affected nerve cells in the brain are stretched or twisted, allowing
potassium to exit those cells, which triggers those cells to depolarize, thus
the phenomenon of seeing stars if the affected area is involved with sight or
ringing in the ears if the affected area is involved with hearing. The exit of
potassium peaks at two minutes after the incident but continues for another 3-4
minutes.
Then, until the chemical balance is somewhat restored, those
neurons (nerve cells) are unable to fire again. Furthermore, in a protective
reflex of sorts, surrounding cells begin to shut down-causing a “spreading
depression.” If enough cells become depressed, confusion, amnesia, and even
loss of consciousness can result.
Meanwhile, in an attempt to recover, the brain starts using
up massive amounts of blood sugar and will continue to do so for as long as 30
minutes. This overuse of this glucose results in the production of lactic acid
which, in excess amounts, inhibits brain function.
For reasons not entirely clear, within two minutes of a
concussion, the body decreases blood flow to the brain by up to 50 percent.
This process continues unabated for 3-4 days but fully normal blood flow may
not resume until an average of 10 days have passed. Consequently, at precisely
the time the brain needs extra fuel to repair itself, it ends up getting less!
While the immediate chemical reaction of the brain to the
concussion is brief and generally completed in 30 minutes, it takes days for
the individual cell and the brain as a whole to restore that chemical balance
which was lost so quickly. Until that balance is restored, the brain doesn’t
work as well and is particularly vulnerable to re-injury.
2nd Impact Syndrome?
This is when an athlete, who has already sustained a head
injury, sustains a second head injury before symptoms and pathophysiology
from the first injury have resolved. Many times this occurs because
the athlete has returned to play too soon either due to not being
truthful with doctors/coaches or not seeing anyone for the problem.
2nd Impact Syndrome is a problem isolated to the adolescent
demographic, primarily due to the developing brain. The second impact can
result in a loss of auto-regulation of the brain’s blood supply, causing
massive swelling. This happens in a very rapid time frame and can be due
to the most minor of “bumps”.
2nd Impact Syndrome has been reported to have a 95%
morbidity rate (life long effect compromising brain function)
and a WHOPPING 50-70% mortality rate (meaning death as
a result).
Always see you family doctor or chiropractor to be evaluated
after a trauma, sport or otherwise. Never return to a sport or activity after a
head trauma without being evaluated.
Dr. Stephen Kelly www.family1stchiro.ca Family First Chiropractic and Wellness 142 Erickson drive, Red Deer 403-347-3261
