Have you or someone you know recently experienced a concussion? Understanding what happens after a concussion can be tricky, especially because it's an invisible injury. If you're seeking more insights into the underlying changes of a concussion, you're in the right place!
Quick Review!
A concussion is a type of mild traumatic brain injury caused by a direct blow to the head or through forces transmitted elsewhere on the body.
What Does This Mean?
A concussion causes both a disruption of physiological function including metabolic changes and interruption of brain signals, as well as a microstructural physical changes that are unidentifiable on standard imaging as in a X-ray, CT, or MRI.
So What Does Happen?
Following a concussion, a neurometabolic cascade of events occurs. Let’s break down that cascade so you get a better picture of what’s happening in real time.
Spreading Depression State
Initially, there are changes in how ions, particularly calcium and potassium move in and out of the cells within your brain causing a depression-like state.
Energy Crisis
As your brain tries to reestablish normal function, it shifts into overdrive utilizing energy pumps. This leads to a mismatch between the energy needed for the job and the supply of energy available. Because the ongoing change in ion movement persists, there is further dysfunction, resulting in a cellular energy crisis.
Cytoskeletal Damage and Axonal Dysfunction
The physical forces that cause concussion also cause damage to many of the microstructural components of the neurons (i.e. dendrites, axons, etc.). This damage and stretching of the neurons decreases the structural integrity of the axons and disrupts signals sent with neurotransmitters.
Altered Neurotransmission and Blood Brain Barrier Breakdown
This cascade also alters the balance of neurotransmitters and the blood-brain barrier. One neurotransmitter, glutamate, is often altered following concussion and impacts memory. The damage to the blood-brain barrier activates neurotoxic substances that induce inflammation and immune responses.
Inflammation
Inflammation also plays a big role following concussion. The inflammation present following a concussion can change the environment in the brain and release pro-inflammatory factors which exacerbate damage, and slow brain tissue and nerve repair.
Need That Less Science-y?
Imagine your brain is the United States of America. The front of your brain (the frontal lobe) is Seattle, WA, and the back of your brain (the occipital lobe) is Boston, Massachusetts.
Our brains are made up of millions of neurons that talk to each other via axons. Your axons connect the lobes of your brain just like the I-90 interstate connects Seattle to Boston. The I-90 is a major highway that allows for the quickest trip from Seattle to Boston. You can think of a concussion like an accident happening on the highway. Instead of traffic flowing smoothly down I-90, it gets diverted to go around the accident, on a longer and slower route. Meanwhile, workers are being sent to the accident to clean it up, much like your brain diverts energy to recovery instead of other cognitive processes. Just like on the road, your brain uses other pathways to avoid damaged areas which can lead to more difficulty in completing a task, or perhaps information just gets lost along the way. Ultimately, the flow of how the brain normally functions has been disrupted, much like the accident disrupts your trip!
Healing Timelines
The concussion cascade happens over a 10-day window where you are at an increased risk for re-injury. While the metabolic phase may recover sooner, we typically see adults recovering in 2 weeks and adolescents in 4 weeks. Prioritizing recovery during this time is crucial!
Understanding the processes behind a concussion is essential for recovery. If you have more questions or are looking for help in your recovery process, reach out to us! We're here to support you on your healing journey.
Please note that the thoughts and ideas presented in this article reflect the author's viewpoint unless stated otherwise. This content should not be considered as individual medical guidance. The details shared are designed to assist readers in making well-informed choices regarding their health and well-being.
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