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The Secondary Injury
Though each traumatic brain injury (TBI) and concussion are unique to each individual, medical science has discovered that the occurrences that follow during the secondary injury are proven to be probable and foreseeable. While the biological events occur in a very calculable fashion, the degree of damage during the secondary injury can be altered if the appropriate measures are taken.
In order to effectively be able to treat a TBI or concussion you must be aware of what takes place during the secondary injury following the initial, also called primary injury.
A multiple of very calculated sequential events occur in the brain; contributing to symptoms, or an increase in symptoms, that can continue for up to 48 hours after the initial primary injury has taken place.
There are three major events that take place effecting brain function during the secondary injury.
1. Ionic shifts
2. Metabolic Changes
3. Impaired neurotransmission
In this blog, we will be covering excerpts from Keys2Concussion’s book, The Complete Concussion Protocol.
The events that take place after the initial head injury or primary injury are referred to as the secondary injury. Most individuals aren’t aware that this secondary injury even takes place.
The secondary injury welcomes an entire new set of symptoms and damaging effects. It is because of this secondary injury that the current concussion assessments on the sidelines during sporting events might not be enough.
Any time the brain suffers a violent force or movement, the soft, floating brain is slammed against the skull’s uneven and rough interior. The internal lower surface of the skull is a rough, bony structure that often damages the fragile tissues within the brain as it moves across the bone surface. The brain may even rotate during this process. This friction can also stretch and strain the brain’s threadlike nerve cells called axons.
When the head has a rotational movement during trauma, the brain moves, twists, and experiences forces that cause differential movement of brain matter. This sudden movement or direct force applied to the head can set the brain tissue in motion even though the brain is well protected by the skull and very resilient.
Upon impact and severe motion brain cells called neurons can be stretched and often squeezed, completely tearing. Neural cells require a precise balance and distance between cells to efficiently signaling and sending messages between cells. The stretching and squeezing of brain cells from these forces can change the precise balance, which can result in problems in how the brain processes information.
Different cognitive functions can be altered depending on the area of the brain that has been effected by the trauma.
Though the stretching and swelling of the axons may seem relatively minor or microscopic, the impact on the brain’s neurological circuits can be significant. Even a “mild” injury can result in significant physiological damage, behavioral and emotional imbalances, and cognitive deficits.
If a person’s head is whipped around, a small tearing effect called shearing occurs throughout the brain, resulting in a diffuse axonal injury. Axons are the hair-like extensions of nerve cells that transmit messages. In a diffuse axonal injury, the messages either get mixed up, or they don’t come through at all.
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