Can a Concussion Lead to a Traumatic Brain Injury?

When the term “concussion” is heard or used, the immediate thought may be, “not too serious.” Yet, while that thought may have some truth because concussions run the gamut of “mild” to “severe,” when we examine the dynamics of a concussion and the definition of a traumatic brain injury, we see that a concussion not only can lead to a traumatic brain injury, but it is one. Mild concussions are usually not life threatening, but all concussions are traumatic brain injuries nonetheless because they alter the way in which the brain works[1]. Here’s why:

The brain is surrounded by the skull. Between the brain and the skull are other protective mechanisms including the meninges and the cerebrospinal fluid, which provide additional cushioning. A blow or jolt to the brain, such as by a fall, an auto collision or some other trauma or head injury can cause the brain to move from its normally stable position within the interior of the skull and actually strike the interior of the skull, resulting in a concussion.

A general working definition of a traumatic brain injury is a penetrating injury or a blow to the head that disrupts normal brain functioning. Symptoms can be mild, moderate or severe depending on the extent of resulting brain damage and can include:

• Vomiting
• Lethargy
• Headache
• Confusion
• Loss of consciousness
• Coma
• Dilated pupils
• Vision changes, including blurred vision, diplopia, intolerance to bright light, loss of eye movement or total blindness
• Dizziness and balance issues
• Slow pulse
• Slow breathing rate with increased blood pressure
• Cognitive difficulties
• Inappropriate emotional responses
• Slurred speech, or inability to understand or to articulate words
• Difficulty swallowing
• Body numbness or tingling
• Facial or eyelid weakness
• Loss of bowel and/or bladder control

Some of the symptoms of a concussion, particularly a severe one, overlap those that are more usually deemed to be traumatic brain injuries, such as:

• Feeling “spacey”
• A feeling of having lost time
• Amnesia
• Dizziness
• Loss of physical coordination
• Slurred speech
• Confusion

In cases of milder concussion,symptoms can be subtle or can resultin the loss of consciousness. The results can be immediate or delayed. They can range from “not just feeling like myself,” to headaches, weakness, vomiting and memory loss. The range and degree of these symptoms and results depend upon the area of the brain affected, the severity of the impact, the age of the individual and other co-morbidities[2].

One of the more widely publicized occurrences of death after what seemed like a “bump on the head,” is that of the late actress, Natasha Richardson, who fell during a ski lesson. News reports stated that she initially appeared fine and even joked about the fall. Ski patrol, following accident protocol, advised her to seek medical help, but she declined. She returned to her room and took a nap. From there, her condition deteriorated to the point that she required transport to the hospital and mechanical life support. She died the following day. This should, very well, drive home the point that “not too serious” should not be ignored.

Once acute care and medical treatment have been concluded for a traumatically injured individual who sustained a severe concussion, post-acute rehabilitation, such as that provided by NeuLife, may be required. The multidisciplinary team at NeuLife develops and implements a Client Goal Plan consisting of clinically relevant services, innovative neurorehabilitative care and other specialized rehabilitation for even the most challenging diagnoses. NeuLife’s goal is to provide care that ensures the best possible, successful and sustained outcomes to achieve the greatest degree of independence for all clients served.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing superior care and specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

2725 Robie Avenue

Mount Dora, Florida 32757