Concussions Not Just A Football Problem: Are You At Risk?

As published on PsychologyToday.com, Feb. 6, 2015
https://www.psychologytoday.com/blog/brain-trauma/201502/concussions-not-just-football-problem-are-you-risk

Part 2 of a 2-part series -- These factors determine your vulnerability

Despite being encased within the stone-like skull, the brain can be easily affected from outside trauma. It’s soft texture is impressionable. So when the brain bounces inside the skull, it doesn’t immediately spring back into shape. The brain is in continual use, carrying out numerous voluntary and involuntary functions every second, so when it experiences trauma -- like a hard fall or direct hit to the head -- normal functioning can be interrupted momentarily or for longer periods of time.

To better understand concussions and you’re level of risk, first we need a better understanding of the brain itself. It’s “command central” literally responsible for regulating or executing every move we make, every word we say, every emotion we feel and every thought we think. It’s precious to life. Therefore, preserving its health is the key to a long life, full of memories, special moments and success.

While concussions are a milder form of brain injury, every person’s brain has a different threshold or margin for absorbing hits. A number of factors influence how well the brain heals and what functions may be altered, including:

  • Heredity and genetic factors — Neurological disorders can be passed down. Although these genetic profiles do not automatically guarantee a future of disorder, they can have an influence on vulnerability or susceptibility of developing problems resulting from concussions. Migraines, for instance, run in families and this condition may make one more vulnerable to the effects of concussion injury.
  • Gender differences — Women are more vulnerable to concussion.
  • Pre-natal health — Brain health is directly related to your mother’s health during pregnancy.
  • History of prior brain trauma — Every hit counts and can add up to higher risk of concussion.
  • Nutrition — Diets void of healthy carbohydrates, omega-3 fatty acids, protein and water can leave the brain gasping for proper cellular development and operation.
  • Exercise — Sedentary lifestyle is associated with reduced blood flow to the brain, creating vulnerability to injury.
  • Sleep — Low levels of deep, rejuvenating sleep force the brain to work harder than necessary, which can leave the brain at a deficit to help with healing due to injury.
  • Toxicity — Alcohol, drug use, and tobacco smoking reduce the brain functioning, and thereby can influence the brain’s ability to sustain a concussion.
  • Exposure — Environmental toxins from drinking water, breathing fumes from paint and nail/hair salons and eating chemicals from foods can also influence brain health.

After sustaining a concussion, the brain grapples to return to normalcy, often building alternate paths for the neural signaling to occur. This can result change in performance which can appear to be a change in someone’s personality.

While the concussion symptoms may have subsided, look out for other odd behaviors, impulsive decisions, personality changes, anger outbursts, emotional imbalances, memory difficulties -- all of which signal problematic neurological disorders resulting from brain damage.

In my practice, I treat patients dealing with a wide variety of symptoms, sleep problems and behaviors. As I begin the initial assessment process, one of the first questions I ask is, “have you ever been hit in the head?”

While most psychiatrists and therapists typically examine behaviors from a psychological point of view -- like understanding triggers anchored from past abuse, traumatic events, heredity, etc. -- as a cognitive neurologist I dig for physiological changes to the brain that may be the root cause of the behavior.

By understanding the overall “health” of the brain, then I can recommend interventions with medication, natural remedies and lifestyle changes. Working in tandem with a psychiatrist or therapist, we can improve the physical health of the brain, as well as give the patient new strategies to deal, improve or change related undesirable behaviors.

Other Concussion Risk Factors

  • The younger you are, the more vulnerable the brain is to concussion, and requiring longer recovery periods. The brain continues developing through the age of 25. Therefore, concussions in our youth and collegiate athletes, can result in greater damage and potential risk to cognitive and emotional impairment.
  • A concussed person is more likely to sustain a repeat concussion, with the greatest risk in the first seven days.
  • Repeat concussions are slower to recover.
  • Anyone who has sustained three or more concussions are more likely to have long-term cognitive impairment and emotional struggles. Concussions can accelerate the onset of dementia and Alzheimer’s Disease.

Another grave concern is the condition known as Second Impact Syndrome, or sudden cerebral swelling that may occur when a second concussion occurs while the brain is recovering from a previous injury. Most people don’t realize the 50 percent fatality rate among individuals who suffer this fortunately rare event. Of the survivors, 100 percent will have permanent neurological impairments.

There is also the more common Post-Concussion Syndrome (PCS). This condition results in various symptoms that may persist for days, weeks, months or even years causing complications with the quality of life. PCS symptoms may include:

  • Physical fatigue
  • Dizziness/vertigo, nausea
  • Headaches: Sensitivity to light, sound
  • Sleep disturbances (difficulty sleeping, staying awake or excessive daytime sleeping)
  • Emotional Impairment (personality changes, irritability, anxiety, depression)
  • Cognitive Impairment (aka “Brain fog” typically involving recent or short-term memory loss, poor attention and concentration)

The bottom line is the brain is a magnificent organ, and it should be treated as such. While getting hit in the head is probably inevitable in our lifetimes, we should be aware that we have the power to influence how well we heal from concussion and prevent future cognitive, emotional and behavioral problems.

About the Author

Harry Kerasidis, M.D is the founder and medical director for the sports concussion management platform XLNTbrain, LLC, based in Maryland. He is also the founder of Chesapeake Neurology Associates in Prince Frederick, Maryland and serves as the Medical Director for the Center for Neuroscience, Sleep Disorders Center and Stroke Center at Calvert Memorial Hospital. His new book, “Concussionology: Redefining Sports Concussion Management” comes out in May 2015.