Concussions, And What You're Wrong About

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Category: Safety

If you didn’t lose consciousness, you probably don’t have a concussion.

Wrong again. Concussions can occur with or without conking out (2). You might feel nothing more than an adrenaline hangover and a bit of a headache once you dust yourself off. But if your brain is concussed, symptoms are likely to start popping up over the course of hours, days or even weeks.

(Note: the presence of brain injury of any kind is greatly increased if loss of consciousness does occur, and the longer you’re out, the higher the risk and severity of injury).

As long as you feel ok, you probably are ok.

Hmm...define ‘ok’. Symptoms of concussion can be physical, cognitive, emotional, or sleep-related, and you can pretty much throw a dart at any of those categories and hit a symptom attributable to brain injury. Symptoms can also be any shade of subtle. You may feel fine physically, but be irritable as hell. Or depressed, can’t sleep or can’t concentrate.

A couple weeks after my concussion, I found myself staring at the directions on the back of a box of instant mashed potatoes and being stumped after “in a large bowl...”. My headaches and dizziness were improving, but clearly, I wasn’t “ok”. Someone who can’t follow two-step directions to make instant mashed potatoes should not be examining sick people and prescribing medications.

Or riding motorcycles. It was nine weeks before I felt “ok” enough to return to work, and I stayed off my bike for twelve. When it comes to brain injuries, 1+1=5. Re-injuring an already injured brain can have devastating consequences, and it doesn’t take much. This is called second-impact syndrome, and it can kill you (3). Or worse.

The length of time it takes to heal from a concussion is complicated and controversial, so the discussion about when it’s ok to get back on your bike is one you should be having with your neurologist or neurosurgeon, not with me or with other riders on some forum somewhere. I will tell you that when people like me who know what I know get a concussion, they take healing very, very seriously.

A good helmet will prevent a concussion.

Maybe, maybe not. If you do sustain a concussion while wearing a helmet, consider yourself lucky; you can be damn sure it prevented something worse.

When you think about it, everything in life is about mitigating risk, isn’t it? You mitigate risk of failure by preparing for whatever it is you want to do successfully. You want a career? You mitigate the risk of sucking at it by educating yourself. You want to have a family? You mitigate the risk of losing it by supporting it. You want to ride a motorcycle? You mitigate the risk of damaging the one thing you need to do anything you want in life...and you wear a helmet.

Sources:

(1) Although there are subtle changes that may be observed in specific sequences of a diffusion-weighted MRI scan, there currently exists no known biologic markers for concussion. [Neurology, published online November 20, 2013.  HYPERLINK "http://www.neurology.org/content/early/2013/11/20/01.wnl.0000437302.36064.b1.short?rss=1" Abstract].

(2) Consensus Statement on Concussion in Sport--the 4th International Conference on Concussion in Sport Held in Zurich, November 2012. The Clinical Journal of Sport Medicine, 2013; 23:89-11

(3) Second Impact Syndrome. Western Journal of Emergency Medicine. 10(1); Feb 2009.

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