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Most people have a friend who has suffered
multiple head injuries. They might have played a
contact sport in high school or worked in a job
where there is a high risk of injury. Usually, we do
not think too much more about it than that.
Concussions feel like a normal part of growing up,
and it almost seems odd if someone hasn’t ever
gotten one. In fact, the University of Pittsburgh
Brain and Spine Injury Program reported that “in
the United States, the annual incidence of sportsrelated
concussion is estimated at 300,000”(5).
This number is staggering, and explains why
concussions seem like such a commonplace in
our society. However, what is not often discussed
is the ramifications of this high incidence. In
recent years, brain injuries have become
increasingly prevalent in the media. In 2015, a
high-profile court case against the National
Football League (NFL) caught the attention of the
nation.
Over 5,000 former football players sued the NFL on
the grounds that repeated head injuries during
their careers were the cause of more severe
conditions that developed later on in their lives.
Many players were suffering from degenerative
neurological conditions such as amyotrophic
lateral sclerosis (ALS) and Parkinson’s disease.
Others suffered from chronic depression and
some even committed suicide. The players
asserted that the NFL downplayed the
consequences of repeated concussions. They
ended up winning the case, settling for up to $5
million per player. This case highlights a gravely
concerning attitude that most people have
towards head injuries: that they are ‘no big deal’
and that, beyond a few months of recovery, have
no further implications. However, this is simply
not the case. Mounting evidence from multiple
longitudinal studies of athletes indicate that
repeated head injuries can lead to dysarthria (a
disorder that affects the muscles of the tongue,
jaw, and face) and apraxia (a disorder in which
the patient’s word comprehension is intact, but
formulation is halted in some capacity). Reports
also indicate that repeated concussions lead to
life-long depression (Guskiewicz et al) and can
contribute to onset of ALS and Parkinson’s
disease (Bazarian et al).
When your head collides with something or is
struck with enough force, the brain immediately
activates its protective damage-control
mechanisms. Firstly, the skull provides an
incredibly hard external layer. This can help
prevent an open head injury, in which the skull is
punctured completely (by a piece of shrapnel, or
say, a railroad spike). However, this boney shell
around the brain can sometimes be
counterproductive, as a significant impact could
cause the cortical surface to collide with the
inside of the skull, possibly resulting in lesions,
swelling, and internal bleeding. The meninges,
three layers of protective tissue of the brain,
begin to essentially bruise. If the impact is great
enough, this could potentially cause even more
widespread damage to the neurons, which is seen
most commonly in Traumatic Brain Injuries.
Concussions tend to be less severe, but certainly
result in some degree of damage.