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What Happens to Your Brain in a Concussion

March is Brain Injury Awareness Month. As schools pause for spring break and kids head outside to play, keeping safety top of mind is especially important. However, concussions — a form of mild traumatic brain injury — can happen to any person, at any age, any time of year. Dr. Robb Matthews, a psychologist at INTEGRIS specializing in neuropsychological consultation, is sharing concussion facts every parent and caretaker should know.

What exactly is a concussion?Dr. Robb Matthews with INTEGRIS

“To put it as simply as possible, a concussion is a sudden change in the way your brain functions following an external force,” Dr. Matthews says.

Did you know? Your brain is the consistency of gelatin. It's surrounded by a hefty cushion of membranes and fluids to protect it and cushion it from sudden shocks, movements and jolts.

Concussions are functional brain injuries, not structural. So unlike a brain bleed, skull fracture or something affecting a physical aspect of the brain or head, a concussion causes injury within the neurons of the brain, impairing its function. Generally, concussions are considered mild to moderate brain injuries, while structural injuries are typically moderate to severe. “With a concussion, the chemicals in the brain get mixed up and the cells are not firing efficiently, which makes it harder for the brain to function,” Dr. Matthews says. As common and minor as they may be, concussions are considered a brain injury and like any injury, they need time to heal properly.

What are the most common causes of concussions?

When most people think of concussions, rough contact sports like football and boxing come to mind, along with severe blows to the head like hitting pavement or taking a punch. However, non-direct forces like a fall or whiplash can also cause enough movement within the skull to lead to a concussion. Across the board, falls are the leading cause of traumatic brain injury.

Did you know? Cycling and bicycle-related falls are the most common cause of concussions among kids of all ages. Football, of course, is a leading cause in older children, along with wrestling, cheerleading and ice hockey, according to Safe Kids Worldwide.

Dr. Matthews emphasizes that it’s not necessarily about the sport, but about risk-taking. “It’s how you play the sport. If you play the sport correctly — protecting your head and neck, using proper form — your risk goes down,” Dr. Matthews says. “Whatever you do, do it safely. Think about risk versus reward.”

Normal concussion symptoms and when to be concerned

Concussion symptoms that mimic those of a severe migraine headache are to be expected.

“Nausea, vomiting, dizziness, even confusion or slurred speech — these are not unusual,” Dr. Matthews says. “If the symptoms are related to migraines, they’re not as concerning. We do want to see those go away pretty quickly, though. They should be seeing improvement within a few hours.”

“Loss of consciousness actually occurs in less than 10 percent of all concussions. If the person does black out, or they have a vacant glassy stare, intense confusion, or any dilated pupil or eyesight issues, go to the emergency room,” Dr. Matthews advises. If symptoms are intense and worsen with time, the individual should be screened to make sure the concussion is not a more serious brain injury.

Again, a concussion affects chemical levels in the brain, so minor functional impairments are normal. It normally takes about a week for chemical levels to stabilize, but certain concussion symptoms may not show up for several hours or even days, so keep a close eye on a loved one if you suspect they may have sustained a concussion.

Answering common concussion questions

Can helmets prevent concussions?

Simply put, no. There is no such thing as a concussion-proof helmet. Helmets can help prevent structural injuries, like skull fractures, but a strong enough force can still cause the brain to sustain internal damage. Even so, wearing a helmet is crucial.

“A helmet can cut down on the amount of force your brain sustains,” Dr. Matthews explains. “That goes for motorcycles and for sports – that force is going to be lessened by a helmet.”

Why is there increased risk for a second concussion after the first one?

“Just like if you sprained your ankle, your brain needs time to heal after an injury. The real issue is when we don’t give the brain enough time to recover. If you don’t give it time to heal, the more likely it can get injured again,” Dr. Matthews says.

Is it OK to let someone go to sleep after a concussion?

“This is one of those old wives’ tales,” Dr. Matthews says. “Tiredness after a concussion is normal, and actually a good thing, because our bodies need sleep to recover properly from an injury — including concussions. Any severe symptom is what want we want to monitor.”

Go to the ER immediately if the person is having seizures, loses consciousness for more than a minute, or has a focal neurological problem like numbness in one or more limbs, or loss of function in an arm or leg. Otherwise, if the person’s symptoms are generally migraine-like and normal, letting him or her sleep is typically OK.

Concussions, like any traumatic injury, should be taken seriously. Be aware of the risks and symptoms, and don’t hesitate to contact your physician or head to an emergency room if your loved one sustains a concerning head injury.

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