Defining a Concussion: Times Have Changed

As medical science has continued to advance, concussion is now recognized for what it is: a mild traumatic brain injury (TBI).

Dr. Kristin Heinen, of the Pediatric Neurology Deptartment at the University of Virginia, explains that a concussion falls under the umbrella of brain injuries. It’s considered mild rather than moderate or severe because nothing will show up on imaging, such as a conventional MRI or brain CT scan.

“There’s no bleeding in the brain. There are no cell fractures showing up… and it is not the same thing as a contusion. You can have hemorrhage, which is bleeding inside of the actual brain tissue, which is a contusion. Sometimes people will mix them up, but they aren’t the same thing.”

It’s important not to minimize a concussion, so using the term “brain injury” is important, says Dr. Joel Brenner of Children’s Hospital of the King’s Daughters, Virginia Beach. “We don’t want people to take it lightly.”

Dr. Brenner explains that a concussion results from some type of trauma to either your head or your body. “It doesn’t have to be directly to your head that causes your brain to basically shake in the skull and which causes a functional disturbance. It’s not a structural disturbance, which is why we can’t actually see the injury on a scan or MRI. It’s more of a chemical imbalance.

“It’s like getting your software messed up on your computer versus, your monitor, your screen and your hardware.”

While concussions are most commonly associated with a direct injury to the head, they can also be the result of severe jolts that shake the body violently. During a car crash, for example, a person’s head might not strike the dashboard or the windshield but as their body goes forward, their head can also shake back and forth. This violent activity can also cause a concussion, says Dr. Brenner.

Fortunately, many concussions are preventable by being proactive. Properly fitted helmets during sports play can lessen the effects of head injuries, baby gates at the top and bottom of stairs can prevent dangerous falls, and using safe and age-appropriate car seats and booster seats for youngsters are a few valuable prevention strategies.