Concussions: The Bare Essentials

by Alex Tran on January 19, 2012 in Opinion - 849 Comments

Here’s a crazy statistic courtesy of CBC Sports. From the beginning of the season through only December 24th (the Maple Leafs had played their 35th game of the season the night before), 457 man-games had been lost to concussions; players had been suspended 77 games, forfeiting nearly $1.3 million in wages.

But what does it mean to have a concussion? How do we get them? Here’s your guide to a basic understanding.

What Are They

In medicine, a concussion is defined as a “trauma-induced alteration in mental status that may or may not involve loss of consciousness”.

Translation: It’s force to the brain that causes a change to your mental responsiveness (ability to open eyes, ability to speak/understand, ability to move).

The most important point to take away from the definition is that it does not necesarily involve a loss of conciousness  (in fact, most concussions don’t involve a loss of conciousness) and as a result, will often go unrecognized. Hockey parents and pee-coaches out there, jot that down.

How They Occur

A concussion happens when a person receives a force to the head. It’s not so much that somebody’s elbow is hitting your brain, but rather it’s something that is causing the motion of your skull to stop abruptly. Your brain isn’t attached directly to the inside of your skull. It is suspended in a protective fluid called cerebrospinal fluid (CSF) and during an impact, continues with its initial motion until it collides up against the skull, causing injury.

Here’s the  next key takeaway point. A concussion does not require a blow to the head. In reality, anything that causes your head to stop or change direction abruptly, may cause the brain to impact itself against the inside of the skull and cause injury. These are called coup and contrecoup injuries.

When the brain impacts against the inside of the skull, it results ina bruise, known medically as a contusion. These areas start to swell and brain tissue will degenerate and die.

Imagine a driver in a car accident. During a collision, the other car doesn’t necessarily hit your windshield, causing the windshield to impact against the driver to cause injury. What happens, is that the other car causes your car to suddenly stop moving. The problem is, the driver still has all of that forward momentum and may end up impacting against the windshield if he/she is not wearing a seatbelt. The brain doesn’t wear a seatbelt.

What Happens Afterward

The most common symptoms after the traumatic period are typically confusion and amenesia. Again, typically without a loss of consciousness. An athlete with amnesia may be unable to recall details about recent plays in the game or details of well known current events in the news. Amnesia may show as a person repeatedly asking a question that has already been answered.

Other Signs & Symptoms include:

• Vacant stare
• Being slow to answer questions or follow instructions
• Being easily distracted or unable to complete activities
• Unaware of time, date and place
• Unusual emotional outburts (crying or getting angry for no reason)
• Inability to walk in a tandem line (one foot in front of the other in a single file line)

More serious complications include seizures or hemorrhage if one of the vessels has been compromised.

Typically, if a player experiences any of these symptoms lasting more than 15 minutes, it is highly recommended that they seek medical attention and that they do not play for one week if it is their first concussion. If it is not their first, it is generally recommended that they sit out the entire season.

Multiple repeat concussions can cause long-term damage and resulting dementia  in a manner similar to that of Alzheimer’s disease (as in the case with Derek Boogard).

Concussions are serious business with significant long-term effects that impact even your ability to carry on a normal day-to-day life. Parents, keep your kids safe.

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