More than just a bump on the head, concussions are injuries to the brain that can have both short and long-term consequences
From high school athletes to friends on a ski trip, concussions are so common that it's easy to dismiss them as bumps, acceptable risks or even rites of passage.
But just how dangerous are concussions?
According to the latest statistics from the Centers for Disease Control (CDC), roughly 2.8 million Americans visit the emergency room for traumatic brain injuries like concussions each year. A 2017 report by the American Medical Association estimates that 20 percent of American adolescents have received a concussion.
With millions of people affected by these brain injuries, it's worth a look at what concussions are and why they're not just a chuckle-worthy "getting your bell rung" to dismiss as minor bumps.
What happens to your brain when you get a concussion?
When your brain receives an injury severe enough to make it bump against your skull—a blow, a jolt or a force that makes your body whip your head around — the function of your brain can change.
The brain is made up of delicate neurons, thin structures that transmit information between cells. When you sustain a concussion, those thin structures can stretch or tear. The damaged neurons can deteriorate, releasing toxins and causing damage to other neurons.
People with concussions can experience a loss of consciousness, memory loss, blurred vision, balance problems, feeling disoriented and mood changes. Depression and anxiety can also be triggered. The brain often heals itself, and many people with concussions return to regular activity within a few days or a week. A single concussion, however, can have a lasting impact.
Why are these injuries so serious?
Some people who experience concussions suffer from post-concussion syndrome (PCS). This condition typically shows up in the form of ongoing headaches that can last for months, and in some cases, years.
Additional symptoms of PCS can be irritability, fatigue, mood changes, insomnia and a loss of concentration and memory — none of which should be taken lightly.
The most dangerous part of receiving a concussion is the risk of additional injury after the concussion. With athletes, there's considerable pressure and desire to return to extreme activity and "prove" you're okay. It's also possible to not know you have a concussion following a rough hit or wipe-out, which puts you at risk to cause more damage to your brain because you think you're fine.
It turns out that the effects of concussions are cumulative. That means that with every concussion you sustain, the damage to your brain can become worse. The damage can be even more severe when the brain hasn't had time to heal from a concussion before sustaining another impact or injury.
This is especially dangerous for athletes who commonly experience minor head impacts as a part of the game they're playing like soccer, hockey and football players. Even a series of small, sub-concussive hits (impacts that don't cause a full concussion) are dangerous over time. There's a significant risk for athletes in these sports to develop what's called chronic traumatic encephalopathy (CTE). CTE develops over time and becomes worse with every blow, resulting in the long-term, permanent degeneration of brain tissue.
Those with both cumulative concussions and a history of repeated sub-concussive impacts are at risk for memory and thinking challenges, impaired judgment/reasoning/problem solving and aggression. CTE can also result in progressive dementia at a young age, usually presenting in a patient's 40s.
What should I do if I get a concussion?
With all of the dangers outlined above, the most important thing to remember is if you or someone you know sustains an injury to or near the head, be on the lookout for the following symptoms:
- Slurred speech
- One pupil larger than the other
- Drowsiness or inability to wake up
- Vomiting or nausea
- Headache that won't go away or gets worse
- Unusual behavior, like aggression, irritability or confusion
With any of the above symptoms, it's essential to see a doctor immediately. It's also important to rest, let your brain recover and avoid returning to any activity where you could sustain even a sub-concussive impact too soon. This could mean sitting out of sporting events or considering whether it's best to let your child continue to participate in high-risk concussive sports like hockey, football and soccer.
While those aren't decisions that are fun or even popular to make, concussions are more than just "having your bell rung" or rites of passage. They're traumatic injuries to the brain — and even one concussion can cause lasting changes for the rest of your life.
E. Napoletano is an award-winning journalist and the recipient of the 2019 Illinois Women’s Press Association first-place prize for her feature on the traumatic effects of family separation policies at the border.