Mild Traumatic Brain Injury
Don’t Risk Further Injury - Let Your Brain Heal
There is an epidemic in the occurrence of concussions and other forms of mild traumatic brain injury. Most people don’t realize that their brain is at continued risk for some time after the initial injury. The risk of occurrence of what is known as “second impact syndrome” demands that the injured brain have time to heal itself to prevent catastrophic consequences.
Cushioning the Brain Against Impacts
The brain sits inside of the cranium, more or less floating in a bath of cerebrospinal fluid (CSF). The surface of the brain is not in contact with the inside of the skull. When a sharp enough blow is delivered to the head, the brain can jerk violently and this may even lead to it bumping into the inner surface of the skull.
Commonly described neurologic alterations associated with concussion include:
- Loss of consciousness
- Memory loss of events both prior to and after the blow to the brain
- Loss of orientation to time, place and person
- Difficulty walking normally or standing normally
- Vertigo (a spinning sensation)
- Difficulty speaking or forming words
Concussion Severity Indicates the Severity of Brain Injury
Concussion severity is graded 1, 2, or 3 according to the following criteria established by the American Academy of Neurology:
- Grade 1: Transient confusion, No loss of consciousness, mental status changes or other symptoms resolve in less than 15 minutes.
- Grade 2: As described above for Grade I, however, the symptoms do not resolve within15 minutes.
- Grade 3: Any loss of consciousness, no matter how brief.
The greater the number of symptoms the more severe the injury to the brain itself.
An Epidemic of Sports-related Concussions
The United States Center for Disease Control and Prevention estimates that of the more than 1.5 million reported head injuries that occur in the United States each year greater than 20% (or >300,000) are sports-related concussions (1). An additional troubling feature of concussive injury is that, once injured, the brain appears to be more vulnerable to recurrent injury. In a two year prospective study involving more than 15,000 player-seasons of high school football, Zemper (2003) reported that the relative risk of concussion is approximately 6 times greater for individuals with a prior history of concussion as compared to those with no prior history (2).
Protect Your Brain
An examination of college athletes who have suffered concussions showed that approximately 10% took longer than 7 days to recover from the effects of the injury (3). While the exact changes that take place in the brain following a mild traumatic injury are not known, it is clear that the brain is vulnerable unless it is given adequate time to recover. Be good to your brain. If you play sports wear appropriate protective gear. Make sure that your helmet fits properly. And without question, if you injure your brain you must give it adequate time to heal. If you don’t the consequences can be severe. Just because you and your teammates call it getting ‘dinged’ doesn’t make it minor for your brain.
Sources
- Centers for Disease Control and Prevention (1997) Sports-related recurrent brain injuries – United States., Morb. Mortal. Wkly. Rep., 46:224-227.
- Zemper, E.D. (2003) Two-Year prospective study of relative risk of a second cerebral concussion. Amer. J. Phys. Med. Rehab., 82: 653-659.
- McCrea M et al. (2003) Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study.; J. Amer. Med. Assoc. 290(19):2556-63.
Brain MRI
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