Each year, typically around the time high schools and colleges begin their preseason athletic training programs in late summer, the news stations write a stories about athletes of all levels who wind up suffering from concussions. Head injuries to the brain that can result in temporary or permanent loss of normal brain function. Brain injuries in school athletics are, unfortunately, not uncommon: The Brain Trauma Research Center at the University of Pittsburgh reports that more than 300,000 sports-related concussions occur in school athletic programs each year in the U.S., and the risk of suffering a concussion while playing sports is about 20% per year of play. Each year, high school athletes sustain more than 62,000 concussions, and 20 percent of high school athletes report they’ve suffered multiple concussions.
Sports-related concussions can be serious, often resulting in significant impairment in thought and motor processes that affect the ability to process information, solve problems and plan.
But youth athletes aren’t the only ones who can suffer from the effects of a knock on the head. Concussions can occur in all types of sports activities, including extreme and recreational sports like motocross, skateboarding, mountain biking, skiing — in fact, just about any type of sports-related activity can put the participants at higher risk for head injuries.
In fact, according to the Brain Trauma Foundation, about 1.6 million to 3.8 million sports-related traumatic brain injuries occur each year in the U.S., affecting athletes of all ages, from youth sports and elementary school playground injuries to high school and college sports to professional athletes and weekend warriors. Alarmingly, many serious concussions result in little to no immediate indications that an injury has occurred, leaving many athletes without the immediate medical care they need to avoid significant and life-changing problems down the road.
Why are concussions such a big problem for athletes? It has to do with the way the brain is “built.”
Concussion and the brain
A concussion may seem like “just” a blow to the head, but the fact is, even seemingly “minor” injuries can cause major damage. Why?
Your brain contains a huge network of nerve fibers and blood vessels, surrounded by a protective layer of spinal fluid that, to some degree, helps absorb tiny impacts and dissipate their effects. But when a more substantial or abrupt blow occurs, the fluid is unable to provide the cushioning necessary to avoid damage to the brain and its nerves and blood vessels. The result: The brain bounces against the inside of the skull causing bruising of the brain tissue and tearing and stretching of nerve fibers and blood vessels. When nerve fibers are torn and exposed, unwanted chemical reactions and exchanges can occur that can cause damage at the cellular level — damage that may go unnoticed for even a few weeks.
Many times, the damage occurs on such a small scale, it can be difficult or even impossible to visualize using traditional diagnostic techniques like magnetic resonance imaging (MRI) or computed tomography (CT or CAT scan). Left undetected, this microscopic damage can cause significant defects to develop over time, including swelling that can compress the brain and block the normal flow of blood, resulting in major brain damage and even stroke.
In some cases, a blood clot or hematoma can form in or around the brain. Left undetected, the clot can grow, causing mounting pressure inside the skull and often resulting in nerve damage and even death. Many hematomas start out so small, they may go undetected. But as blood leakage continues inside the skull, the clot can slowly enlarge, sometimes causing no symptoms for days or even weeks after the initial injury.
Symptoms of concussion
The symptoms of concussion can vary substantially depending upon the force of the impact and the amount of immediate damage. Just because someone appears “normal” following a head impact, that does not mean that no damage has occurred. Damage to the tiny structures inside the brain can occur on a cellular or even molecular level, or it may progress and become worse over time.
When symptoms do occur, they typically include some or all of the following:
- Severe or persistent headache
- Confusion or loss of memory
- Problems with vision including sensitivity to light
- Dizziness or problems with balance or coordination
- Nausea or vomiting
- Difficulty concentrating
- Problems with basic senses like smell or taste
- Persistent ringing noise in the ears
- Difficulty speaking or finding the “right” words
- Changes in mood including extreme irritation or excitability
Many times, people who suffer concussions may not remember what happened during the injury or immediately afterward. Others may report feeling fine and appear uninjured after the impact.
The risks of concussion are very real, but with the exception of a few scattered news reports, especially at the start or height of high school or college football season, the long-term impacts of concussions often go unnoticed or unreported. As a result, many athletes and trainers are unaware of the potential effects of even minor concussions and may overlook symptoms or fail to report injuries to the head or neck.
To combat this issue, the Centers for Disease Control and Prevention launched its Heads Up: Concussion in Youth Sports initiative aimed at providing information about head injuries to coaches, parents and even the athletes themselves.
Understanding head injuries is important; but the problem is, once an injury occurs, the costs of treatment can be substantial, and while medical insurance may cover some costs, the costs of many injuries far exceed the limits of personal medical insurance.
Part II On Concussions
In part II of this series, we’ll look at some of the myths associated with concussions, including a deeper look at “hidden” concussions and second impact injuries, as well as the heavy costs and complicated liability issues concussions and traumatic brain injuries can involve.
