Technically no, a cerebral hemorrhage is a much more acute problem that usually requires urgent medical intervention. What doctors and researchers are concerned about concussion is the effect of multiple concussions over a long period of time.
Dr Nasrallah says that a single concussion is not necessarily a life-changing event, and most people recover well from even a bad blow to the head. Where people start to see problems is when they are repeatedly hit on the head and the brain is not given time to heal. Instead of healing completely, the damaged brain tissue suffers more trauma, which can then take even longer to heal, so that the injury becomes cumulative.
The connection between the subject, says Dr. Nasrallah, is that even if there are ways to test a concussion, just because one seems to have recovered does not mean that his brain is ready to heal.
“Many athletic codes now have guidelines for spending some time not playing and showing no clinical symptoms before they are allowed back on the field,” she says. “The problem there is that clinical symptoms are not parallel to the brain changes – symptoms can go away, but the brain can still heal, and if you come back and have even a small impact, it can hurt your brain again.”
What happens to someone who repeatedly has concussions?
Your brain is very good at self-repair, but enough trauma over a long enough period of time can cause it to begin to degrade. Researchers have identified a condition called chronic traumatic encephalopathy (CTE), which is exhibited in the brains of people who have suffered repeated head injuries, including many former professional sports players.
CTE can cause memory and thinking problems, personality changes, aggression, depression and suicidal ideation, and later life dementia. But it can only be diagnosed properly postmortem. Former AFL players Danny Frawley and Shane Tuck, who both suffered from depression before their deaths, were diagnosed posthumously with CTE. A recent survey of brains of former sports players donated to the Australian Sports Brain Bank found that more than half of the brains – 12 out of 21 – had CTE.
Dr Nasrallah says contact sports like AFL and rugby codes are at high risk for concussions, and therefore players are at high risk for long-term effects like CTE.
Regarding the Venables situation, a number of other players in many sports have been forced to retire early due to concussion risks, including Rugby League player Boyd Cordner last year. Victorian cricketer Will Pucovski is currently pushing to play despite at least 11 concussions while playing, although there are now differences of opinion among medical experts over that number.
However, Dr Nasrallah says that assessing risk is not as simple as declaring a fixed number of concussions, or any other guidelines with a size. “People are very different and respond to injuries differently based on a range of factors, from their genetics to environmental factors,” she says. “And that’s where the research comes in – we need a lot more information on what’s going on with these players in the long term so we can advise sporting bodies on what is the best way to inform practice.”
How widespread are concussions?
Because concussions are so difficult to diagnose properly, there are concerns that they are under-reported in professional athletes, even with an increase in the use of concussion protocols for a range of contact sports.
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But the thing that gives researchers and sports groups a break is the potential for harm to children’s brains. Amateur sports at the junior level often see headaches and other injuries, but concussion protocols are often less strict and less likely to be followed.
The effect of repeated concussion on developing brains can be as bad, if not worse, than that suffered by adults. And there may be long-term implications.
“It’s a whole new ball game when we talk about brain development because it’s so sensitive to change, and when it’s a big trigger, you do not know how the brain responds, and what the effects will be in the long run. “says Dr. Nasrallah.
“I think it’s important to start that group with a magnifying glass because I think they’ve been seriously under-reported so far.”
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A number of recent studies have indicated that there are long-term implications for children suffering from concussion, including one from this week’s Children’s Hospital of Eastern Ontario Research Institute in Canada that found a link between concussion in childhood and an increased risk of mental health found. Problems.
So what can be done about concussion?
Full-contact professional sports will always carry a risk of concussion for players, and managing that risk will be a key issue for athletic bodies in the future. Many sports now use Head Impact Assessments (HIAs) during a game to see if players are able to stay on the field, but this may not capture all cases of concussion.
There are also calls for building a long-term program of regular brain scans to monitor players’ brain health and to mark any warning signs that they may be suffering from too many brain injuries.
Dr Nasrallah says as with most medical problems, a nuanced, multi-pronged approach is needed to ensure that cases that slip under the radar of one test are picked up by another.
“A multimodal approach is best. There’s not one thing that will tell you all the information. You need a set of measures to diagnose and manage concussion injuries. And then personalize it – a clear account of your personal medical history. from a player, whether genetically and physically predisposed to concussions, and manage them accordingly.
Examine, a weekly newsletter written by national science reporter Liam Mannix, is sent out every Tuesday. Below is an excerpt – sign up to receive the full newsletter in your inbox.
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