Concussions affect thousands of adolescent athletes every year, presenting long-term brain damage and severe health complications. Understanding the latest research and the details can provide awareness about the side effects of concussions. It can also alert parents, coaches, and healthcare professionals on strategies to protect their children from these concussions.
Concussions: Causes and Effects
A concussion is a traumatic brain injury "that results in temporary loss of normal brain function"(Khoi). Concussions occur by direct trauma to the head and, or rapid acceleration-deceleration of the head. Situations like blasts, falling, or getting hit in the head can all cause concussions. Any large movements to the brain (jarring) can cause a concussion. According to an article by the American Association of Neurological Surgeons, short-term concussions include confusion, headaches, vision disturbance, imbalance, memory loss, ringing ears, and other loss of sensory details. Usually, short-term effects subside within a couple of days, but repetitive concussions can cause persisting effects that remain for indefinite periods.
Repetitive concussions can increase chances for neurodegenerative diseases later in life. A National Institute of Health(NIH) article analyzed previous epidemiologic research and concluded repetitive head impact exposure increases the risk for diseases such as Alzheimer's. These repetitive concussions generally happen after the occurrence of a singular concussion. A singular concussion can increase the chances for another severe concussion to occur. The first concussion involves a sudden movement that "can stretch and damage brain tissue and trigger a chain of harmful changes within the brain that interfere with normal brain activities"(Wein). It can then lead to nausea, dizziness, memory loss, and confusion which can last from the period of a couple hours to a couple days. Understanding the causes and effects of concussions can be useful in seeing which parts of the brain are affected and how to stop them.
Parts of the brain affected
When a concussion occurs, the brain rapidly shakes, causing damage tofrontal lobe, the temporal lobe, and the hippocampus. The National Institute of Medicine examined neurological data from the Baltimore Longitudinal Study of Aging where they found people with a prior concussion had greater atrophy in the white matter within the temporal lobe, and the hippocampus. They also found that the microstructure of the white matter was contrasting. This damage is apparent later in life as well and causes structural damage to the brain. Concussions can also cause long-term psychiatric damage such as personality change and cognitive impairment. Concussions can cause cognitive impairment which includes "impaired speed of information processing, poor memory, and executive problems"(Fleminger). These cognitive changes end up impacting one's life severely. Personality change is also evident after a concussion, with trends of poor motivation, tendencies to be self-centered, and loss of awareness of other people's needs becoming more common in people with experience with concussions. These personality changes tend to occur because of dysregulation in the cingulate gyrus or the anterior insula as found by Dr. Alina Fong. This dysregulation is caused when the anterior insula or cingulate gyrus is damaged. Both those parts of the brain deal with emotions and impulse control so dysregulation causes them to malfunction. The Concussion Alliance also found that during a concussion, the neurons are stretched and broken. This makes it harder to communicate which explains the memory loss and other symptoms people experience after a concussion. Certain parts of the brain are mainly affected during a concussion which explains the symptoms that occur after a concussion.
While the specific changes range from person to person, Fleminger found that there is a trend for negative changes to occur with symptoms of anxiety and depression being more common than others.
Difference of effects: Adults and Adolescents
Adolescents and adults react very differently when faced with a concussion. Adults are known to have physical symptoms like "headache, balance problems, and fatigue" (Perrine). Meanwhile, adolescents exhibit more behavioral symptoms like irritation, drowsiness, and insomnia. The change in effects is caused by the difference in development between the two brains. An adult's brain has fully developed and the myelination process is complete. The myelination process is the brain strengthening already made connections by adding myelin sheath around nerves. This process improves the speed of connections made by neurons. In an adolescent, this process is still incomplete which can be the cause of different symptoms such as "an extended loss of memory after a concussion"(Perrine). These effects generally do subside within a week in the case that they are not too serious. Another part of the brain that is affected differently in adolescents is the prefrontal cortex. Since it is still developing, it's susceptible to damage from a concussion. The damage done to the prefrontal cortex could cause attention deficits, hyperactivity, or conduct disorder as stated in an NIH article. The concussions that occur in adolescence can also have effects lasting into adulthood. A study found that in a group of 100,000 traumatic brain injury (TBI) patients, "who suffered a concussion at a young age throughout their lives and found that they were more likely to experience mental health problems as adults and struggle at work"(Allen). Symptoms such as memory fog can last throughout one's life if the concussion is severe enough. With the immense amount of side effects and implementations, concussions can cause in an adolescent's life preventative measures should be taken.
Preventative Measures for Parents and Coaches
Currently, not all people take the necessary precautions when it comes to dealing with TBIs. Certain simple precautions such as avoiding head-to-head collisions in sports could save one's child from a major concussion. Wearing protective headgear whether it be in sports, or even biking as the head should always be protected. Other forms of protection include not driving under the influence and always wearing a seatbelt, in the case of a car crash. In the case of older people, falls should be prevented as they can have a higher risk of sustaining life-threatening damage from a seemingly safe fall.
By understanding the causes, symptoms, areas of damage, difference of effects, and preventive measures, parents, coaches, and healthcare professionals can veer through the right path to ensure the adolescent doesn't suffer a concussion and doesn't suffer lasting damage. With patience and time, we can emancipate adolescents and adults to protect themselves from the lasting effects of concussions and lead a life free of hindrances.
Written by: Vedant Dave
Cited Sources:
Than, Khoi d. “Concussion.” American Association of Neurological Surgeons, www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Concussion Accessed 1 May 2024.
Wein, Harrison. “A Bang to the Brain.” National Institutes of Health, U.S. Department of Health and Human Services, 13 July 2017, newsinhealth.nih.gov/2013/05/bang-brain#:~:text=%E2%80%9CA%20concussion%20can%20arise%20from%20the%20brain%20moving,the%20brain%20that%20interfere%20with%20normal%20brain%20activities
McAllister, Thomas, and Michael McCrea. “Long-Term Cognitive and Neuropsychiatric Consequences of Repetitive Concussion and Head-Impact Exposure.” Journal of Athletic Training, U.S. National Library of Medicine, Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5384827/
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Sandel, Elizabeth. “What Happens to Your Brain When You Get a Concussion?” Concussion Alliance, www.concussionalliance.org/what-happens-to-your-brain Accessed 1 May 2024
Giza, Christopher C., and David A. Hovda. “The Neurometabolic Cascade of Concussion.” Journal of Athletic Training, U.S. National Library of Medicine, Sept. 2001, www.ncbi.nlm.nih.gov/pmc/articles/PMC155411/
Fong, Alina. “Personality Changes after a Brain Injury or Concussion: Cognitive FX.” Personality Changes After a Brain Injury or Concussion | Cognitive FX, 23 Feb. 2024, www.cognitivefxusa.com/blog/personality-changes-after-a-brain-injury-or-concussion#:~:text=For%20example%2C%20we%20might%20use,disruption%20due%20to%20the%20injury
“Understanding TBI: Part 2 - Brain Injury Impact on Individuals Functioning.” MSKTC, msktc.org/tbi/factsheets/understanding-tbi-part-2-brain-injury-impact-individuals-functioning Accessed 1 May 2024.
Danielli, Ethan, et al. “A Review of Brain Regions and Associated Post-Concussion Symptoms.” Frontiers in Neurology, U.S. National Library of Medicine, 3 Aug. 2023, www.ncbi.nlm.nih.gov/pmc/articles/PMC10435092/
Williams, June D, et al. “Lasting Consequences of Concussion on the Aging Brain: Findings from the Baltimore Longitudinal Study of Aging.” NeuroImage, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/32702483/ Accessed 1 May 2024.
Perrine, Kenneth. “Concussion 101: Children versus Adults.” Neurological Surgery, neurosurgery.weillcornell.org/about-us/blog/concussion-101-children-versus-adults#:~:text=Adults%2C%20however%2C%20tend%20to%20have,irritability%2C%20drowsiness%2C%20and%20insomnia Accessed 1 May 2024.
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