A concussion is a very common injury in cycling crashes, car accidents and falls. Many of them go unrecognized, undiagnosed, and therefore untreated. People are overly accepting of concussion symptoms and often fail to even mention them to their doctor. Many people believe it’s not possible to get a concussion without striking their head or being knocked unconscious. That is simply not true.
What Is a Concussion? How Is It Caused?
A concussion disrupts the function of the brain and is considered a mild brain injury. It is caused when brain cells, called neurons, become damaged or disrupted. The location of the damaged cells within the lobes of the brain will determine how someone is affected. It’s very easy to expect a concussion in accidents in which a cyclist’s head strikes the ground or a passenger in a vehicle violently strikes their head against something in a crash.
Concussions can also be caused by a sudden jolt of the head as well as the classic whiplash action involved in many accidents. When someone’s head is propelled forward and then suddenly propelled backward, the momentum of the head causes their brain to forcefully strike the inside of the skull. The effect is about the same as the head striking the ground. It’s the crushing of the brain against the inside of the skull which causes the damage.
The cells immediately beneath the area where the skull is impacted may be damaged. When the brain is jostled back and forth, multiple areas of the brain may be affected. Rotational forces within the skull can cause shearing damage to brain cells. All of these forces may cause tiny areas of bleeding and bruising of the brain cells in addition to damage which is less severe, but still disrupts the brain’s normal functioning.
While loss of consciousness is common in a concussion, it is not required. Many people simply have a feeling of being dazed, “out of it” or having a “foggy” feeling in their head. It may not be dramatic at all.
Everyone's Concussion Symptoms Will Be Different
Many people who suffer concussions do not have overwhelming symptoms, although they do occur. More frequently someone will experience a wide variety of subtle changes in the way their brain functions. They will notice these changes by symptoms such as excessive sleepiness; inability to recall people or events; not remembering the time immediately before, during or after an accident; headache; word finding difficulties; changes in personality or temperament; getting lost even in familiar surroundings; visual perception changes; and many others.
Quite often the injured person is the last to realize the full extent of what they are experiencing. These changes may be observed by family members, coworkers or friends who spend time with them.
Not Everyone Will Recover
From a medical perspective, the odds are these changes will slowly improve over time. Many physicians are somewhat dismissive of post-concussion symptoms, making very little note of them in their chart on the assumption the patient will “get over it." Often, patients do recover as anticipated. But many do not. A significant percentage of patients who do not improve within the first month or so will go on to have permanent changes in their brain function and personality, affecting them the rest of their lives.
When someone has suffered a concussion, or a suspected concussion, even if not recognized by first responders or in the emergency room, it is vital that these subtle but persistent changes be reported to and documented by their treating physician.
It’s particularly important to remember that a treating physician may make a note of brain injury symptoms initially, but not ask about them during follow-up visits. When these symptoms persist, the patient must bring them to the doctor’s attention.
If the doctor continues to act as though they are not significant, consideration should be given for referral to a neurologist who has experience dealing with concussions and mild brain injuries. Tests can be done to confirm brain damage, although many serious brain injuries are documented where there are no positive findings on these tests.
If someone you love suffered a concussion or a brain injury as a result of an accident, call our office, we are here to answer your questions.