Medical: What Exactly Is A Concussion

MasterclassConcussion

Motorcycle riding is an inherently dangerous sport, but it’s one we love to do. Most of us wear helmets in order to prevent trauma to our head from the inevitable spills and crashes, but do we really know what to do if we take a whack to the head?

A concussion is a trauma-induced alteration in mental status that may or may not involve loss of consciousness. Headache, confusion, and amnesia are the hallmarks of a concussion and may be present immediately or even days after the event (especially in younger patients). 

Knowing whether you had a concussion after hitting your head can be a difficult endeavour. I have personally seen many riders continue on the trail the entire day after hitting their head and ride as if nothing happened. Then I later learn that they did not remember riding the trails or motocross track! The point is if you hit your head and you have a headache, confusion, or amnesia, get some help. 

Many symptoms are subtle and include headaches, persistent neck pain, slowness of thinking and speech, getting lost, easily confused, constant fatigue, decreased energy, lack of motivation, mood changes, changes in sleep patterns, difficulty remembering, concentrating, making decisions, and dizziness. Major concussion symptoms include visual problems, loss of smell, ringing in the ears, nausea and/or vomiting, and passing out. If you experience major symptoms after hitting your head, you should proceed directly to the nearest hospital. 

Many tend to use descriptive language when trying to describe what a concussion really is. Many call it a ‘brain bruise’ and this is very inaccurate. In fact, there are no findings on neuro-imaging studies in most cases. The best way to understand a concussion from a medical perspective is that it is an energy disturbance caused by the abruptness of the trauma inflicted to the brain.

Many studies of concussed brains show blood flow changes on functional MRI scans. The concussion actually depletes the neurons of energy and this is what puts the area of injury under much higher risk to future damage.

When the tissue is damaged there is a release of neurochemicals that cause inflammation, such as zinc and iron, and this puts the brain at a much higher risk of permanent injury. Concussion severity seems to correlate quite well to the release of these toxic substances and decreases in cerebral blood flow. 

One thing is for sure that when you have a concussion, you should rest the brain. Resting the brain allows for the complete recovery of the neural tissue involved. The real danger of a concussion is when the tissue initially injured in the first concussion is damaged by a second. These are the types of situations that lead to permanent brain damage after concussions.

What should be done once a concussion occurs? 

If you think you have a concussion you should certainly present yourself to a hospital for evaluation. Most hospitals will run an MRI scan to determine if there is any physical damage to the brain. Realise that most of the studies will be negative.

Once you are cleared from the hospital, rest is one of the key factors. By rest, I mean you should do what your body tells you. If you feel so bad that you have to stay in bed then that is probably what you should do. If you feel more energetic and awake then certainly go take light walks in the sunlight, get back into nature a little bit, and try to engage your brain in activities like reading or learning another language. 

Now that we know exactly what a concussion is, and the best course of action for you to take should you suffer head trauma while out on the trails, in the next issue of Adventure Bike Rider we’ll look at the many ways that you can care for yourself after suffering a concussion to minimise the potential damage to the brain and speed up recovery. 

Information in this article is not intended to replace the advice of a medical doctor nor the treatment you may receive in a hospital. If you have an injury to your head, please have it properly evaluated by a medical professional.