Anatomy of a Concussion

Hello all and happy new year! With January being observed each year as National Winter Sports/Traumatic Brain Injury (TBI) Month in the U.S., we thought we’d focus our attention to the topic of concussion, and try to increase awareness and patient education on the many traumatic brain injuries (including concussion) caused by participation in sports each year.

Concussion and traumatic brain injuries

What is a Concussion?

First off, I like to begin these topics by defining the problem – What is concussion and what are traumatic brain injuries? (often referred to as acquired brain injuries in Europe).
Traumatic brain injuries (or TBIs) are events that affect the functioning of the brain. They can be mild events (for example, what we typically call concussions) or severe, leading to death.

The brain is surrounded by a liquid cushion (called cerebrospinal fluid or CSF) and a bony structure (the skull). The skull and CSF act to protect the brain from injury. When the human body is jolted suddenly, the brain can be joggled around within the cushion of fluid and bump into the bony skull. The injury event itself does not have to be a direct hit to the head; even a hit to the body that forces the head to move in a sudden fashion can cause a mild traumatic brain injury, or what we refer to, or hear reference being made to, as a concussion.

Concussion and Traumatic Brain Injuries

3D image of a brain from Pocket Anatomy

While it is not exactly clear what happens within the brain, the current theory is that there is a disruption of the transmission of messages along the axons (the fine projections that come off the body of the neuron and connect neurons to each other as they transmit chemical messages). Depending on which part of the brain is affected by the injury event, the symptoms of mild traumatic brain injury (concussion) will vary.
Scope

Ok, so let’s take a look at the scope of this problem: Youth football and even professional football have been in the spotlight recently as more information becomes available about the dangers to the brain of concussive events. Over 3 million concussive events were reported in 2012, double the number reported in 2002; and about one third of the events happen at practice. Alarmingly, almost half of all of these events occur in connection with high school football.

Estimates for Europe suggest that sports related brain injury account for close to 300,000 injuries each year, with winter sports such as skiing and ice-skating accounting for close to 20,000 brain injuries.

Our team really liked the novel approach taken by Dr. Giza from UCLA in raising awareness about concussion, and the effects head trauma has on our brains with this highly visual demonstration. Nice work folks!


Credit: Dr. Giza from University of California, LA.

Preventing the problem

No matter the cause, mild traumatic brain injuries must be taken seriously, as they can cause long-term and permanent damage to the brain, and in severe cases can lead to death. Preventing them is the most important approach to the problem; using these guidelines will make sports play safer:

  • Wear approved, well-maintained and properly-fitted protective equipment, such as helmets.
  • Stipulate a no hits to the head or other dangerous play in hockey and other sports such as skiing, snowboarding or snowmobiling.
  • Practice safe playing techniques and encourage athletes to follow the rules of play during all winter sports events.
Concussion and traumatic brain injuries

3D image of a brain from Pocket Anatomy

Responding to concussion

The Centers for Disease Control and Prevention (CDC) encourages coaches and parents to follow a four-step action plan when a concussion is suspected during sports activities. The four steps include:

1. Remove the athlete from play.
2. Ensure that the athlete is evaluated by a healthcare professional experienced in evaluating for concussion.
3. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion.
4. Keep the athlete out of play the day of the injury and until a healthcare professional experienced in evaluating concussion says they are symptom-free and it’s OK to return to play.

Patient Education

Our friend Dr. David Holmes works closely with american football players and their families. One such player is Greenbay Packers, David Bakhtiari who has this to say about the role Pocket Anatomy plays in player education:

“The Pocket Anatomy app was very beneficial to me and my understanding on the origin and severity of my injury. With the 3D view and easy navigation around body parts, it gave me a pleasant and influential experience to further my understanding of the anatomy.”

David Bakhtiari, Green Bay Packers

David Bakhtiari, Green Bay Packers

David Bakhtiari, Green Bay Packers

Additional Viewing:

http://cerebrum.com/cms/category/youth-sports/
https://www.youtube.com/watch?v=XPbRqiUkNDA
https://www.myheadfirst.com/videogallery
https://www.youtube.com/watch?v=XnIRso_04Ks
https://www.headway.org.uk/about-brain-injury/further-information/statistics/
http://www.teambraininjury.co.uk/brain_injury_the_statistics.html
http://www2.warwick.ac.uk/fac/cross_fac/healthatwarwick/newsandevents/events/poster/list/78.pdf
http://www.internationalbrain.org/brain-injury-facts/