Concussions: The Elusive Injury

Last week we talked about concussions in our class.  Namely, what they are and what causes them.  The latter question is easy enough to answer, turn on any high contact sport and odds are you will likely see an athlete receive a concussion.  Yes this massive deceleration that is experienced by our brains within our skulls creates enormous stress on the nerve cells within the brain.  Basically what happens is that after the brain suffers an injury, the nerve cells within our brains lose their polarization.  This polarization is necessary for bodily function as signals are carried most effectively by electrical impulses which are enabled by said polarization.  Now in order to counteract this depolarization the cells use a pump on their outer surfaces which allow the transfer of charged ions to into the cell.  The only problem with this is that they need energy in order to function, and after the brain suffers a collision blood flow into the brain is significantly reduced.  This means that nutrients normally being carried into the brain in sufficient amounts are no longer going to where they need to go, so now our pumps which are trying to restore the natural state are using up resources which are becoming more scarce as time goes on.  Eventually, we reach a point our brain cells undergo a cellular energy crisis where we see a depressed state of metabolism in the cell.  This crisis is especially dangerous when we take into account the threat of subsequent concussions as in this state the brain cells are in worse shape to counteract the injury.  Now once again this is a very basic overview of what happens during a concussion.  In truth we also see the generation of lactic acid, decreased magnesium level in the cell, free radical production, inflammatory responses, and altered neurotransmissions playing a role in concussions.

In our discussions for this week we mostly stayed on the topic of concussions and contact sports.  Namely, these types of injuries are so easily misdiagnosed or so easy to cover up by the players that a second more serious injury is very likely to occur.  We talked about many different ways that one might go about trying to address these two issues as there are many factors involved.  For example, we still do not know very much about concussions, namely what specific forces on the brain cause a concussion.  Scientist use sensors in the helmets of the players in order to monitor the kinds of forces acting on them and as such we are making progress in this area.  Another important topic that was brought up is that athletes are only getting stronger and faster as time goes on due to better training methods, so the odds that we will see more players dealt concussions in the future are pretty good.  Lastly and possibly most important is simply the players themselves.  If they are not educated about the symptoms of concussions they are putting themselves in danger, more to the point if they simply ignore their symptoms after they receive a concussion and decide that it is not worth getting barred from their normal training for 7 days.

I thought that we had an enlightening discussion this week and it just goes to show that sometimes there really aren’t any easy answers to a problem that is as complicated and multifaceted as this.