Concussion: When the skull just isn't protection enough
Football and soccer players tend to be at risk for a concussion, however, the injury can happen to anyone. In fact, every 21 seconds, one person in the United States experiences a traumatic brain injury (TBI).1 A TBI can be a serious head injury causing permanent disability or death; however, of the 1.5 million Americans who sustain a TBI each year, 75% of the injuries are concussions or other minor head injuries.2
Any blow or jolt to the head, some of which seem harmless, can cause a concussion. Falling off a ladder, falling in the bathtub, or tripping on a rug are just a few ways you can sustain a concussion in your home. A concussion can also occur while playing a contact sport such as baseball or football, while skating, or while riding a skateboard.
What is a concussion?
Three membranes, collectively called the meninges, provide protection by separating the brain's soft tissue from the rigid wall of the skull. Three layers cover the brain; the dura, a tough, leathery outer covering; the arachnoid, a thin inner layer with threadlike strands that attach it to the pia mater; and the pia mater, which is a thin, delicate layer tightly attached to the surface of the brain (Fig. 2). In addition to the protection of the layers, cerebrospinal fluid surrounds the brain and cushions it as well. Even with these protections, the meninges and deeper tissues within the brain can become bruised when there is a blow or jolt to the head or when the head is severely jarred or shaken.
How do you know you have a
Immediately after you injure your head, you may feel dizzy or confused and your head will probably hurt. A bruise or bump can appear very quickly and you may feel nauseated. Your vision may be blurred and you may not remember exactly what happened. If the symptoms of a concussion do not last very long, it does not mean you are uninjured. Some symptoms appear right away, while others do not show up for days or weeks after the injury.
Screening and diagnosis
If your first head injury is mild, you can sometimes return to your sport during the game; however, depending upon the severity of your injury and the symptoms, you may not return to the sport for days or weeks. After numerous head injuries, your physician may recommend that you find another sport. Second impact syndrome can occur when anyone, not just athletes, sustains a second or third concussion before the previous head injury has healed. Therefore, it is important that you receive clearance from your doctor before you return to any activity that can put you at risk for another head injury.
You are at a higher risk for a concussion to occur if you play a contact sport; however, more concussions occur off the field than on each year. Falls in your home and automobile accidents top the list of causes of head injuries. To avoid a concussion, do what you can to protect yourself; wear a seatbelt and wear a helmet when riding a bike, motorcycle, horse, or skateboard. Make your home as fall-proof as possible by removing area rugs that slide, installing handrails, and using non-slip mats in the bathtub and shower.
For more information about brain injuries and how to prevent them, visit the Brain Injury Association of America's Web site at www.biausa.org and the Centers for Disease Control and Prevention's (CDC) Website at www.cdc.com.
Patrick J. Fernicola, MD