I will be the first to admit that I am a long-time fan of the horror and mystery author Stephen King. I think that my fascination for his books is because my mother forbad me to read them when I was younger (looking back, that was probably a good call on her part).
Nevertheless, adult me has read almost everything he has published. I am currently in process of reading “Duma Key,” a novel about a man who suffered a trauma brain injury (TBI) which left the Broca’s area of his brain damaged. Because of the damage to that specific region, he has trouble with language processing and speech production. Also, he is now psychic. I bet you didn’t see that coming.
Psychic powers aside, the injury to the brain is based in truth. Moreover, TBIs account for an estimated 1.3 million emergency room visits and about 50,000 deaths annually.
One of the most common injuries is the concussion. We have heard a lot about it in the news lately, particularly from the NFL and other contact sports. To understand more about it, we first have to take a look at the anatomy of the brain itself.
Inside of our skull, the brain is a three-pound organ that gives birth to our higher functions such as intelligence, emotion, recall, and the five senses. It also controls many of the functions critical to life (sometimes called vegetative functions) like respiratory and blood pressure control.
You might recall that the brain is divided into three main regions, almost like separate brains. The cerebrum is top portion, largest in size, and controls our “higher functions.”
The cerebellum and brainstem are located under the cerebrum and act to coordinate the functions of the body as well as regulating those vegetative functions.
The outside of the brain appears to be folded into solid ridges. These ridges are composed of two different types of cells: grey matter (the actual cells of the brain) and white matter (the long fibers that carry the messages of the brain cells).
The white matter is sometimes called axons, or long-chain nerves. One of the more common threats to the brain after a hit is diffuse axonal injury (DAI). Remember, the brain is mainly composed of those long axonal chains (white matter), therefore, a DAI is a generalized injury to these nerve chains.
A concussion is the lowest form of a DAI. Common signs and symptoms of a concussion include headache, amnesia, confusion and temporary loss of consciousness.
The good news is that concussion style injuries to the head are usually mild and heal on their own. However, it is never a good idea to take repeated blows to head or put yourself at risk of another injury while the concussion is healing.
Remember, these nerve chains swell and need time to go back to normal. This is part of the stringent NFL concussion protocol that was instituted several years ago. It might be necessary to see a physician. Getting checked out after a TBI is always a good idea, no matter how minor.
However, if you experience any vomiting, loss of consciousness for more than 30 seconds, irritably, changes in vision, or slurred speech, you should immediately seek care.
Avoiding concussion is fairly easy with some practice. Always make sure that you and your children are wearing protective helmets and other gear when on bicycles or ATVs.
Buckle your seatbelt when you are driving to reduce the risk of head injuries. Make your home safe by removing anything that could trigger a fall. Keep in mind that a concussion is only the lowest grade DAI. There are many others that are far worse and can be life-threatening. Keeping your noggin safe has to be a top priority, and it doesn’t take a psychic to see that.
Stay safe out there.
M. Eric Williams, MS, NR-P is a Mississippi native and Instructor of Emergency Medicine. He is a Doctoral Candidate and has 15 years’ experience in healthcare. If you have questions or comments, you may contact him at eric.williams@jcjc.edu.
