How Common Is Brain Injury?

Most people are surprised to learn that a relatively low level of force is able to cause minimal brain dysfunction and that every mild insult succeeding the first one has a cumulative effect on a brain’s response to life’s demands. Slightly slower processing and reactions times are the first effects of a mild injury, even without a loss of consciousness.

Mild traumatic brain injury, also called closed head injury, intact skull injury, or post-concussion syndrome, is a condition where an individual suffers a blow to the head and subsequently develops symptoms.  The “dings” that occur in sports, the confusion following the blow to the head that made us see stars, the “mild” rear-ending that made your glasses fall off, all have varying degrees of consequence on the physical structure of the brain and its function.

How Does the Brain Get Hurt?

A concussion results from “the rapid acceleration or deceleration” of the brain within the skull. The force behind the brain’s change in velocity is often from direct contact to the head, but can also come from indirect forces like whiplash which may result from a car accident or from being blindsided by a player on a soccer field. The brain, having all of the momentum of its forward motion added to the sudden impact momentum, ends up being bounced around onto the bony cage of the skull. Knocking about within the skull cage bruises the vulnerable areas of the brain.  Diffuse damage to these areas causes attention deficits, slow thought processing, and diminished bilateral integration.

Following a concussion or head injury, emergency room physicians commonly order CAT scans or MRI’s to rule out serious injuries. Unfortunately, these scans usually don’t reveal mild to moderate damage because they are examining only the structure of the brain and not how the brain is functioning. There are other tests such as the quantitative EEG (QEEG), PET, or SPECT scans that evaluate how the brain is functioning in comparison with normative databases.

Concussions can also occur from repeated blows to the head that do not appear to be injuries at all, for instance heading the ball in soccer, repeated falls during skate boarding and simple blows to the head in basketball, football and volleyball.

According to Comstock and Crutchfield, it’s not head-to-ball contact that poses the greatest concussion danger for younger players, but rather player-to-player or player-to-ground contact. 

Over time, the effect of these incidents becomes cumulative until that seemingly inconsequential event that becomes the tipping point as it is followed by symptoms that interfere with memory, sleep, mood, pain, and the ability to get along with people.

The neurological effect of concussions and other serious head trauma in sports is a topic of considerable interest to scientists, as well as to athletes and their parents.

• A 2013 study, by scientists at Imperial College London, found that the force of an average header was like a punch from an amateur boxer.
• A 1989 study found “significantly increased incidence of EEG disturbances” in the brain scans in 69 professional players in Norway.
• A 2003 study of 60 soccer players in Florida aged 18 to 29 found that those who headed the ball the most showed impairment on neuropsychological testing.
• A 2007 study of 10 college soccer players observed “decreased gray-matter density and volume” in parts of the brain.
• A 2011 brain-scan study of experienced, adult soccer players found subtle structural changes in certain parts of the brain that might be associated with repeated slight impacts.

Concussions can cause problems in a wide variety of areas such as:

• Attention span
• Memory
• Depression
• Headaches
• Coordination
• Fatigue
• Ringing ears (tinnitus)
• Social withdrawal
• Impulsive behavior
• Slowed mental processing
• Mood swings, irritability, short temper

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SIGNS AND SYMPTOMS OF CONCUSSION

SIGNS OBSERVED BY COACHING STAFF

• Appears dazed or stunned
• Is confused about assignment or position
• Forgets an instruction
• Is unsure of game, score, or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior, or personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall

SYMPTOMS REPORTED BY ATHLETE

• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light
• Sensitivity to noise
• Feeling sluggish, hazy, foggy, or groggy
• Concentration or memory problems
• Confusion
• Just “not feeling right” or “feeling down”

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