Concussions

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