Anatomy of a brain injury
Newton’s laws of motion say that an object in motion stays in motion unless acted upon by an outside force.
Imagine a soccer player running down the field who stops suddenly using his head to make contact with a fast-moving ball. The ball’s motion gets stopped by the head. The brain’s motion gets stopped by the skull. This gets repeated game after game. That’s what happens when a brain injury occurs. The brain can literally get knocked into your skull.
“The skull is the natural helmet to protect the brain,” explains Dr. Raina Gupta, a neurologist with Advocate Medical Group in Chicago. “And there’s fluid surrounding the brain to help absorb injury, but there will be some impact on the brain that the skull simply can’t handle, and we’re slowly learning how extensive that impact can be,” she says.
Dr. Gupta says recent research reveals that brain injuries or concussions cause the brain to age prematurely because the brain is affected at the cellular level.
“The changes that happen at the level of the cell of the brain mimic advanced dementia,” says Dr. Gupta.
In both dementia and concussions, abnormal proteins are deposited in the cells.
“We think these abnormal proteins accumulate over time, so if you look at a 40-year-old professional athlete’s brain who’s has repeated concussions, it could resemble an 80-year-old person’s brain who was not an athlete. So it would look like the athlete had prematurely advanced dementia,” explains Dr. Gupta, who holds concussion clinics.
It’s possible to not even know you have sustained a brain injury, she says, so particularly for athletes, it’s important to know the signs. Physicians often use a standardized sports concussion assessment tool that identifies signs within the first 24 to 48 hours that an athlete may have a concussion, including:
- Having a headache that gets worse
- Feeling very drowsy or can’t be awakened
- Inability to recognize people or places
- Repeatedly vomiting
- Behaving unusually, seeming confused, irritability
- Having seizures
- Feeling weakness or numbness in limbs
- Trouble with balance
- Slurring speech
It’s difficult to know how significant an injury is until the symptoms show up so if you suspect you might have had an injury, Dr. Gupta says go to the emergency room or call your doctor and monitor your symptoms over time.
Prevention is key
Unfortunately, there are no magic pills or ways to reverse the process, says Dr. Gupta.
“However, cognitive rest improves time to recovery. I feel that increased total sleep may have the potential to improve time to recovery as well,” she says. Those with concussions need more sleep than usual because sleep helps the brain to recover.
She also explains that after an initial injury, people improve, however, after repeated injury (also known as chronic traumatic encephalopathy), “you can have retained deficits, and may be left with long-term consequences, so the most important thing is prevention.”
Dr. Gupta believes that in addition to improving protection, such as better helmets, she says that policy changes are needed in youth sports, and an increased awareness of what long-term consequences of head injuries can be.
Even President Obama recognizes that the growth in concussions, particularly from sports, needs attention. In an interview, he once said, “If I had a son, I’d have to think long and hard before I let him play football.”
Good places to start for policy change might be no direct head hits in football during practice, only in games, and no heading the ball during soccer practice.
“With increased awareness we can keep help to keep our kids safe. This may lead to changes in the rules of the game all together. This is one policy we can contribute to as a society,” Dr. Gupta says.
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health enews staff is a group of experienced writers from our Advocate Health Care sites, also including freelance or intern writers.