Imagine you’ve just woken up. You know that today is an important day but you can’t remember why. You ask your spouse if today is and they give you a concerned look. It’s your anniversary, how could you have forgotten such an important day. Would it ever cross your mind that it might be because of a concussion you received in high school? Concussions are far more dangerous than previously believed, they have side effects that can affect you for the rest of your life. Side effects that could possibly ruin your life. From a mere headache to the threat of degenerative brain diseases, concussions at a young age could have catastrophic impacts on a person’s life.
In order to explain the risk of concussions, I must first establish what a concussion is and, explain how it affects the brain. According to the Mayo Clinic, a concussion is “a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance, and coordination” (Mayo Clinic, 2017). The Center for Disease Control, CDC, agrees with this claim by listing a concussion under the category of traumatic brain injuries, stating that “The severity of a TBI may range from “mild,” i.e., a brief change in mental status or consciousness to “severe,” i.e., an extended period of unconsciousness or amnesia after the injury.”(CDC 2017) The CDC also states that “A TBI is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.” (CDC 2017) Through these two statements concerning concussions, I can establish that a concussion is a traumatic brain injury caused by a blow to the head that may result in brain function. Of course, the severity of a concussion will vary from injury to injury, but they’re all along the line of a traumatic brain injury. When a person receives a concussion, the cerebrospinal fluid and the meninges surrounding the brain fails to absorb the shock of an impact, causing the brain to hit the skull. This can cause a variety of symptoms ranging from a headache to eventual death given the right circumstances.
The consequences of concussions are not taken seriously by all. This might be because 87% of Americans don’t know how to define a concussion. In particular, the younger generations, mostly high school students who are the most vulnerable, don’t give concussions a second thought. A concussion is irritating to high school athletes, for example, there are kids here at OHS who have suffered seven or more concussions while only reporting and being treated for around three of them. I cannot stress how dangerous this is, In fact anywhere from 50%-80% of concussions go unreported and untreated. (Robbins, 2017) This is dangerous on numerous levels. Concussions can affect the academic performance and social lives of these kids, and multiple concussions can lead to chronic traumatic encephalopathy, and an increased risk of being diagnosed with Alzheimer’s or Parkinson’s disease. So, as invincible as high school kids feel, they need to realize the dangers that they face when a concussion strikes them out of nowhere.
The most relevant problem high school students face when it comes to concussions, is the challenge of going to school. They are faced with the challenge of an exciting and stimulating environment that pushes their brain too far after sustaining trauma. The symptoms of a concussion can cause a multitude of problems when in a school environment, students with a concussion may suffer from headaches, mental “fogginess”, and concentration issues that will affect their performance in class. In fact, 88% of students reported problems like these in a recent study (Ransom, 2017), while 77% of kids from the same study had trouble with homework and not taking. Obviously, this would not be the best for students in high school as they can fall behind quickly. In addition to having troubles learning and paying attention in class, school may also be dangerous for students with concussions. The high stress and high stimulus environment can cause the brain to overwork and slow the healing process. The loud noise in the hallway and constant use of technology in our modern school systems also has an adverse effect on students with concussions, both of these can cause symptoms to worsen and slow healing. Students with concussions should limit stimulus, access to technology should be limited, work should be prioritized to limit brain stimulus that could cause symptoms to worsen, and possibly limiting the amount of time that a student must attend school. Test and homework should be extremely limited if not eliminated from a student’s schedule. In some cases, if the concussion is severe, a student should be at home or at the very least attend school for half of the day to reduce the exposure to stimulation that could cause more harm and slow the healing process. The student could also have the option of an online class that will allow them to avoid unnecessary stimulation and stop working if the work becomes too much for them to handle. This coupled with sufficient sleep could help put the student back on track and get him/her back into classes.
If the terrible effects on a person’s daily life weren’t enough, concussions can also cause drastic changes in the future. Multiple concussions or even subconcussive hits can cause a variety of problems with the brain. One of these is chronic traumatic encephalopathy or CTE. CTE is disease common in those that have received multiple hits to the head, especially football, hockey, and soccer players. As seen in figure 1, CTE causes cerebral atrophy or loss of neurons (as much as 30% of all neurons in all lobes) and the signal pathways between them. Essentially causing the brain to shrink in size. Atrophy in the brain obviously causes some pretty severe problems. With the loss of so many neurons and pathways, it’s possible to lose speech functions and decision-making skills, while also suffering from dementia and strokes. CTE also causes tau proteins to detach from microtubules and tangle together. Once the tau clumps together, it causes more clumps to form in the brain. This disrupts neurological pathways. These clumps of tau keep forming after head impacts have stopped. In figure 2 it’s is possible to see the clumps of tau in the brain, the dark spots, obviously, these should not be in the brain. This along with the first figure allow for a good view of how the brain degenerates and how severe it can get.The build-up of the tau protein in this figure could eventually end up looking like that in the first figure due to the progressive nature of the disease. Symptoms of the disease usually become apparent around the early to mid-thirties, typically around a decade after the trauma occurs, and causes devastating symptoms that can ruin a life. These symptoms consist of suicidal thoughts, cognitive impairment, emotional instability, aggression, speech difficulties, motor impairment, olfactory abnormalities (problems with the sense of smell), and dementia. Currently, there is no cure for CTE and with the exception of a recent study, can only be diagnosed after death. CTE is more common than it should be, it has been found in high school, collegiate, and professional athletes at alarming percentages (of those autopsied). According to a study at Boston University (CNN, 2017), CTE was found 110 of 111 deceased NFL players (99%). Players ranged from 23 years old to 89 and covered all three levels of play. 21% of high school only players were reported to have been diagnosed with CTE, and 91% of college players were also diagnosed with CTE. 177 of 202 brains studied had the debilitating disease. CTE is a dangerous disease that can be prevented if concussions are taken seriously at all ages.
Unfortunately, CTE is not the only neurological disease that can be caused by repetitive head trauma. Both Parkinson’s disease and Alzheimer’s are thought to have links to brain injury and abnormal protein build up. Although it is not the largest risk stemming from concussions, Alzheimer’s disease has been linked to concussions by Michelle Mielke of the Mayo Clinic. Alzheimer’s is a severe form of dementia that is currently irreversible and is the most common form of dementia and shares similarities with CTE. Concussions are thought to speed up the process of Alzheimer’s in those who are genetically at higher risk for the disease. Concussions have been linked Alzheimer’s through the thickness of lower cortex, the first region of the brain affected by Alzheimer’s. This link to cortical thickness was found in a younger audience with the average age of 32, showing that these symptoms are not the result of age or plaque build up over an extended period of time. (Hayes, 2017) Those who suffered more serious concussions were shown to be more likely to develop Alzheimer’s, unfortunately, the study was confined to the brain scans of 500 people. Hopefully, a larger focus group can allow for more information on the connection between Alzheimer’s and concussions to be discovered and reported.
Parkinson’s disease has also been linked to head trauma, concussions being the most associated with the disease. Parkinson’s is a disease that affects the central nervous system, and is mostly known for uncontrollable tremors in the hands of the elderly. Currently, Parkinson’s is treatable, unlike CTE and Alzheimer’s, through the use of medication and deep brain stimulation, The main cause of Parkinson’s is the formation of Lewy bodies in the brain, they are clumps of protein that are similar to those found in people diagnosed with CTE or Alzheimer’s disease. A study done by the University of Washington reported that those with traumatic head injuries have a 350% higher chance of developing Parkinson’s disease.(Park, 2016) Even a single head trauma could result in a decline in cognitive health and lead to terrifying side effects, however, the study did focus on those who had lost consciousness. Those who had lost consciousness for extended periods of time had a much higher rate of progression of Parkinson’s’ disease. This being said, a concussion will not directly cause Parkinson’s disease. It will only increase your chances of being diagnosed as you age. It has also been speculated that there is a connection between the protein buildups called Lewy Bodies and the buildup of tau in the CTE, this, however, has not been researched thoroughly but is important to mention.
The effects of concussions do more than injure an individual. What about their family? The degenerative disease that can be caused by concussions could rip families apart. Parents and grandparents could wake up one day and not remember their kids, or they could wake up every day as a different person. Fueled by chemical imbalances in the brain and the loss of neurons they’d have no control of their emotions, aggression, and paranoia are common in those with Alzheimer’s and CTE. The emotional toll that these preventable diseases cause on the individual suffering from the disease itself and the family members that have to deal with it is staggering. According to one study ”one half of family members claimed they had developed psychological or social problems (such as sleeping problems and depression) of their own to such an extent that they also needed help and support.” (Priory Group, 2017) while dealing with a family member that was cognitively impaired or had a mental illness.
The repercussions of concussions can be terrifying. They could the quality of life for you and your family, make you go insane, or forget everything that is important to you. Be it short term symptoms that affect your everyday life or long-term degenerative brain diseases, concussions can have a drastic effect on your life. They need to be taken more seriously, it is important that the long-term effects be made aware to those who put them self at risk. Especially by the youth of our generation to help lower the number of people diagnosed with diseases such as CTE in the foreseeable future.
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