Posts
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Joined
8/21/2006
Location
Tucson, AZ, USA
Edited Date/Time
1/24/2012 9:07am
In case you didn't read some of the posts in the other thread:
A concussion is a bruise within the tissue of the brain. Depending on exactly where it occurs, and the severity of the trauma, there may/will be loss of consciousness. In a general way, we use the length of this unconsciousness as a way to grade the severity of the concussion. Other details, from the examination of the patient to specific radiology studies may also assist with this grading, and we often use this to determine return to activity recommendations. Google will get this grading system for you if you desire.
As I mentioned, a concussion is a bruise of the brain. A bruise is a torn blood vessel that leaks blood out of the vasculature (usually veins, but sometimes small arteries) into the surrounding tissue. As you can imagine, this is not where it belongs, and it irritates these tissues, in the case of your brain, sometimes causing/contributing to the associated symptoms in a concussion. If the bleeding is more severe, be aware that there is nowhere for the swelling associated with the bruise to go! If it gets bad enough, the pressure in the skull gets high enough to prevent your heart from pumping blood to the brain tissue, and it can die. Or, the pressure can force some of the brain tissue through the thumb-sized opening at the base of the brain....which already happens to have the spinal cord running thru it. When this happens, you usually die.
So, think about your little bruises you get on your arms and legs from minor trauma...even they take up to a week (or more) to completely resolve. And then, for several weeks after, you may feel a little knot with/without tenderness. This is the normal process of the body to resorb the blood that is outside of the vessel in the surrounding tissue. Now translate this to your brain....if you ride too soon, before the broken blood vessel has formed a good, mature clot, your risk of re-tearing the site is high! And if it bleeds, it almost always bleeds more severely than the first time! Now you may be thinking, "it's been a week, surely the clot is mature now." Well, maybe it is fairly mature, but there's also a knot of hematoma there that is not fully resorbed, and is still irritating to the tissue. You do not want to be shaking that thing around with another blow to the head either. This has to have time to heal, hence the recommended healing times before returning to activity.
You may recall that Helper had a prolonged timeframe for his return....he had had a large battery of baseline testing that they were able to compare to his post injury measures, and they didn't let him come back until he was back to baseline. We very well may see this become a standard for contact sports...time will tell
Bottom line is give these things time to heal!!!
The floor is open for questions....
MR
A concussion is a bruise within the tissue of the brain. Depending on exactly where it occurs, and the severity of the trauma, there may/will be loss of consciousness. In a general way, we use the length of this unconsciousness as a way to grade the severity of the concussion. Other details, from the examination of the patient to specific radiology studies may also assist with this grading, and we often use this to determine return to activity recommendations. Google will get this grading system for you if you desire.
As I mentioned, a concussion is a bruise of the brain. A bruise is a torn blood vessel that leaks blood out of the vasculature (usually veins, but sometimes small arteries) into the surrounding tissue. As you can imagine, this is not where it belongs, and it irritates these tissues, in the case of your brain, sometimes causing/contributing to the associated symptoms in a concussion. If the bleeding is more severe, be aware that there is nowhere for the swelling associated with the bruise to go! If it gets bad enough, the pressure in the skull gets high enough to prevent your heart from pumping blood to the brain tissue, and it can die. Or, the pressure can force some of the brain tissue through the thumb-sized opening at the base of the brain....which already happens to have the spinal cord running thru it. When this happens, you usually die.
So, think about your little bruises you get on your arms and legs from minor trauma...even they take up to a week (or more) to completely resolve. And then, for several weeks after, you may feel a little knot with/without tenderness. This is the normal process of the body to resorb the blood that is outside of the vessel in the surrounding tissue. Now translate this to your brain....if you ride too soon, before the broken blood vessel has formed a good, mature clot, your risk of re-tearing the site is high! And if it bleeds, it almost always bleeds more severely than the first time! Now you may be thinking, "it's been a week, surely the clot is mature now." Well, maybe it is fairly mature, but there's also a knot of hematoma there that is not fully resorbed, and is still irritating to the tissue. You do not want to be shaking that thing around with another blow to the head either. This has to have time to heal, hence the recommended healing times before returning to activity.
You may recall that Helper had a prolonged timeframe for his return....he had had a large battery of baseline testing that they were able to compare to his post injury measures, and they didn't let him come back until he was back to baseline. We very well may see this become a standard for contact sports...time will tell
Bottom line is give these things time to heal!!!
The floor is open for questions....
MR
...and I admit, I have broken some of the rules....I did learn something tonight.
BTW - for those that do not know....the "dr" on the front of his screen name is the real deal.
This explanation deserves it own place, like in an FAQ. While injuries like broken clavicles and knee injuries are very common among the riding community head injuries can have longer term and farther reaching effects on or ... um ... um ....lives. Ya that's it.
Joking aside I wonder how the injuries I had as a teen and how they were treated have contributed to issues I deal with now in my 40's like migraines, concentration and moods.
The Shop
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Luxon 4-Post Bar Mounts
$189.95 - $239.95
Doc Bodnar wrote up an article a couple years ago that helped change the pro's understandings of concussions. It was taken seriously and the reason Stewart pulled out of an SX after a crash(Atlanta, I think).
The main thing MXr's need to understand is the dangers of second-concussion syndrome. You hit hard and black out even for a short time, stay off the bike at least a week. I know one pro for sure that nearly died from it in SX.
The baseline testing Hepler did was because his agent at the time, Traction Ent, learned about it from UPMC and insisted on it. Smart move.
Been there, done that.
Post a reply to: Ok, short lesson on concussions....