What is a Concussion?

A concussion is a brain injury and is defined as a complex pathophysiological process that affects the brain, typically induced by trauma to the brain. It can be caused either by a direct blow to the head, or an indirect blow to the body, causing neurological impairments.

Symptoms usually reflect a functional disturbance in the brain and may present themselves in the following categories:

  • Physical (headaches, nausea)
  • Cognitive (difficulty with concentration or memory)
  • Emotional (irritability, sadness)
  • Maintenance (sleep disturbances, changes in appetite or energy levels)

What happens to the brain during a Concussion?

The adult brain is a three-pound organ that floats inside the skull. It is surrounded by cerebral spinal fluid, which acts as a shock absorber for minor impacts. When the brain moves rapidly inside the skull, a concussion has technically occurred.

One common scenario that can lead to a concussion is a direct blow to the head or a whiplash effect to the body. The impact rapidly accelerates the head, causing the brain to strike the inner skull. When the head decelerates and stops its motion, the brain then hits the opposite side of the inner skull.

The second common scenario is a rotational concussion, in which the head rapidly rotates from one side to another causing shearing and straining of brain tissues. In either case, delicate neural pathways in the brain can become damaged, causing neurological disturbances.

Does age and gender play a role in Concussion management?

There are distinct differences in age when it comes to managing sport-related concussions. Recent research demonstrates that high school athletes not only take longer to recover after a concussion when compared to collegiate or professional athletes, but they also may experience greater severity of symptoms and more neurological disturbances as measured by neuropsychological and postural stability tests.

It is also estimated that 53% of high school athletes have sustained a concussion before participation in high school sports, and 36% of collegiate athletes have a history of multiple concussions. Because the frontal lobes of the human brain continue to develop until age 25, it is vital to manage youth concussions very conservatively to ensure optimal neurological development and outcomes.

Data suggests that female athletes sustain more concussions than their male counterparts. A major reason results from females not having the same head-neck muscle mass as males, which contributes to frequent and greater whiplash movements on the brain itself.

What are some long-term consequences of multiple concussions?

Long-term effects of multiple concussions are currently being studied by researchers around the globe. Research shows that multiple brain injuries may result in many mental health issues including the following:

  • Mild cognitive impairments
  • Depression
  • Anxiety
  • Substance abuse
  • Homelessness
  • Chronic traumatic encephalopathy (CTE)
  • Increased incidents of suicide

This is serious. While we are still elucidating the causes of these long-term effects, it is imperative that a person fully recovers from one concussion before risking a subsequent one. Failing to do so can lead to additional neurologic damage or even death. Given this new understanding, managing concussions requires specialized, comprehensive, and state-of-the-art approaches.

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