Understanding Concussions: What Happens When Your Brain Gets Injured?

Each year, millions of people in the United States experience concussions from sports and recreational activities. But what exactly happens to your brain during a concussion, and why can the effects be so varied and sometimes long-lasting?

The Delicate Nature of the Brain

Imagine your brain as a delicate mass, similar in consistency to jello, housed within the protective layers of membranes and the hard shell of your skull. This design usually provides excellent protection. However, a sudden impact can cause the brain to shift and collide with the skull's interior. Unlike jello, the brain isn't uniform; it's composed of a complex network of roughly 90 billion neurons. These neurons communicate via long, fragile axons, making them vulnerable to stretching and tearing upon impact.

What Happens During a Concussion?

When a concussion occurs, several things happen:

• Disrupted Communication: Neurons stretch and tear, impairing their ability to transmit signals effectively.
• Toxic Release: Damaged axons degenerate and release toxins, which can lead to the death of additional neurons.
• Varied Symptoms: This cascade of events results in a range of symptoms, including:
  • Blackouts
  • Headaches
  • Blurred vision
  • Balance issues
  • Mood and behavioral changes
  • Memory and cognitive difficulties
  • Sleep disturbances
  • Anxiety and depression

Because every brain is unique, the experience of a concussion can differ significantly from person to person.

Recovery and the Myth of Sleep Deprivation

Fortunately, most concussions heal completely within days or weeks. Rest and a gradual return to activity are crucial for allowing the brain to recover. Contrary to popular belief, it is a myth that you should avoid sleeping after a concussion. Unless doctors suspect a more severe injury like a brain bleed, sleep is beneficial for healing.

Post-Concussion Syndrome (PCS)

In some cases, individuals may develop post-concussion syndrome (PCS), where symptoms like persistent headaches, learning difficulties, and behavioral changes can last for months or even years after the initial injury. Playing through a concussion or returning to sports too soon increases the risk of developing PCS.

The Danger of Subconcussive Impacts

Subconcussive impacts are lower-impact jolts to the head that may not cause immediate, noticeable symptoms. However, repeated subconcussive hits can lead to severe degenerative brain diseases over time. For example, studies using Diffusion Tensor Imaging have shown that soccer players who frequently head the ball can experience damage to the structural integrity of their axon bundles, impacting short-term memory.

Chronic Traumatic Encephalopathy (CTE)

An overload of subconcussive hits is linked to Chronic Traumatic Encephalopathy (CTE), a degenerative brain disease characterized by mood and behavior changes in the 30s and 40s, followed by cognitive and memory problems that can lead to dementia.

The Role of Tau Proteins

CTE is associated with the clumping of tau proteins, which normally support microtubules within axons. Repeated head impacts can damage microtubules, causing tau proteins to dislodge and form clumps. These clumps disrupt neuron transport and communication, leading to the breakdown of brain connections. The clumping of tau proteins can spread throughout the brain even after head impacts cease.

The Importance of Reporting and Treating Concussions

Data suggests that a significant percentage of concussions go unreported and untreated, often due to difficulty in recognizing the symptoms or pressure to continue playing. Ignoring concussions can undermine recovery and lead to dangerous long-term consequences.

Our brains are not invincible and require protection and care to heal from injuries. Recognizing the signs of a concussion and seeking appropriate treatment are essential for safeguarding brain health.