The Conundrum of Concussions ... Who Gets Them ... and Crucial Symptoms to Watch For
What happens during a concussion?
A concussion occurs when there is either a blow to the head or the head is moving and strikes a fixed object. What happens to the brain is very different from what happens to the skull. The skull stops moving immediately, but the brain continues to slide and move back and forth. The brain is a soft organ that doesn’t break or crack; it simply deforms itself. A concussion can be hard to diagnose. It doesn’t create bruises or hemorrhages on the brain, and there’s no imageable defect. What’s worse, some concussions don’t even exhibit symptoms for 36-48 hours. In the old days, you had to have a loss of consciousness before it was called a concussion. We’ve since learned that only about 10 percent of concussions or significant brain injuries have loss of consciousness.
Are some people more susceptible to concussions?
We believe so. Gender may be one reason. If you take college sports with identical rules, women always lead in the number of concussions. Some of that may be due to neck musculature. Men have more of a muscular buffer that will absorb a lot of energy and avoid whipping the head back and forth. Hormones may play a role as well. There may be times of the menstrual cycle when women are more vulnerable to injury. And apart from gender, genetics may have a part in concussions. We believe there are genetic susceptibilities to brain injury and to the failure to recover from brain injury.
What else do we know about concussions today that we didn’t know 5-10 years ago?
We know that relatively minor symptoms can in fact represent concussive injuries. Those symptoms include a sense of dizziness; being bothered by light or sound; vertigo; lack of ability to focus or concentrate; a sense of being dinged; and seeing stars. Fortunately, we know how to better treat concussions. There’s a six-stage process a player must now go through before he or she can return to play. At the high school level, that process takes about 2 ½ to 3 weeks. Unfortunately, we don’t have a drug or specific intervention to help kids get back on the field faster. That’s the type of thing we explore at UT Southwestern. We’re here to move the needle on treating brain injuries.
Dr. Batjer, an internationally acclaimed neurosurgeon, is Chair of the Department of Neurological Surgery at UT Southwestern. For the past three years, he has co-chaired the National Football League’s Head, Neck, and Spine Committee. He also holds numerous leadership roles in organizations that are charting the future of neurosurgery.