Mild traumatic brain injuries (TBI), colloquially referred to as concussions, have been receiving a great deal of news attention given the dangers involved in high-impact sports, such as football. Concussion research has surged in recent years thanks to concern from the athletic and military communities. Despite increasing efforts to understand its nature and effects, concussions remain subject to a remarkable amount of myth, mystery, and misinformation. A recent article in Scientific American Mind discusses six key things that should be known regarding concussions.
You do not have to hit your head to get a concussion. A concussion can occur when the head is merely jolted, either from a blow or from a sudden stop. For instance, when someone is rollerblading and falls, going from 20mph to 0phm, they might not have experienced a direct blow to the head, however the sudden stop can cause the brain to slosh around within the skull. In fact, doctors are seeing more and more concussions that do not involve direct head impact, especially among military personnel exposed to bomb blasts. When the head is suddenly jolted, the brain can bounce perilously within the skull.
If you think you might have a concussion, make sure you do not hit your head again. Minimizing the risk of a second concussion is paramount because getting two in a row can lead to long-term complications. Research suggests that the brain acts like an electrical grid, and when it is hit or jolted, the brain shuts down electrical signaling to quickly add more sodium to brain cells in order to restore equilibrium. This explains loss of consciousness, and also begins to illustrate why getting hit again might come at a huge cost. Second impact syndrome cases are fatal more than 50 percent of the time.
It is okay to fall asleep after getting a concussion. The idea of keeping someone awake after a concussion is rampant in pop culture. In reality going to sleep a few hours after a concussion is fine and probably even helpful to your recovering brain. It must be noted that this refers to concussions and not more severe brain trauma such as a brain bleed. Experts say that if the person in breathing normally, not having a seizure, not vomiting or waking up with a worsening headache, there is no reason to wake the person up fully and interact with them.
Prolonged “brain rest” is not necessary—and it may even be harmful. After receiving a concussion, doctors in the past have instructed patients to rest for a week or more—no work, socializing, physical exertion, reading or watching TV. This recommendation is based on outdated information that was actually never evidenced-based in the first place. Original evidence was based on preventing an athlete from getting back in the game too early and risking a second concussion. However, this useful information for eager athletes got misapplied to the general public. A recent randomly controlled clinical trial found that concussed participants who were put on strict rest for five days post injury reported more symptoms than those who resumed activity after two days.
Rest is not the only treatment available. Concussion clinics are becoming more and more common, especially in metro areas and regions with large hospitals. At these clinics, a multidisciplinary team offers a variety of physical and psychological treatments.
It is impossible to predict which symptoms a person will have and how long recovery will take—but that may change soon. New research findings have shown that loss of consciousness has no relation to the severity of post-concussion symptoms or recovery time, as it was once believed. Concussions, in addition to causing a sodium flow, do permanent damage to the brain’s axons, and the amount of damage indicates if recovery is going to be quick or painfully slow. Further, a growing body of research is suggesting certain red flags that might be indicators of a longer recovery. Researchers have concurred that the factors that most robustly predicted a slow recovery were a history of mental health issues, such as depression, and post injury anxiety.