Can Brain Damage Occur without a Concussion?
Surprising New Brain Injury Study
A study of 24 high school football players looked at radiological changes in the brain in the absence of frank concussion. The study presented to the Radiological Society of North America has raised concerns. As part of the Wake Forest Kinematics of Impact Data Set or KIDS, players wore accelerometers on their helmets during practice and games. The accelerometers measured number of hits and the force of each impact. Prior to the season commencing, the 16 to 18 year-olds had diffusion tensor imaging or DTI scans, a specialized form of MRI. These scans are able to visualize fine structures within the white matter of the brain. After the season, scans were repeated and results compared.
Players identified as heavy hitters (9 of the 24 subjects) had appreciable white matter abnormalities in a specific portion of the brain known as the corpus callosum and other deep myelinated nerve tracts. Researchers noted that not one of these players had experienced a concussion that season, yet their brains had been physically altered.
These are the same areas identified as injury points for mild traumatic brain injuries. The corpus callosum is a key part of the brain that serves as the bridge of nerves that connects left and right hemispheres. Damage her can lead to many problems with speech, memory, hand eye coordination, vision and more.
This study only looked at physical and physiologic changes in the brains, and did not assess the athlete’s brain function. An earlier study in 2013 however, found that in Division I college football and hockey players, the more the brains changed physically, the more learning and memory problems were encountered.
“Repeated ‘sub-concussion’ blows to the head may be the cause of damage deep within the brain that leads to cognitive problems later”
Other Causes of Brain Injuries
Of course football and hockey are not the only instances of head injuries. Children whose heads are still developing may be susceptible to changes and therefore cognitive dysfunction from other blows to the head that do not present as obvious concussions. Multiple playground falls, bicycle and skateboard spills, etc over a long period of time may result in serious brain problems.
Auto Accident Brain Injuries
Another obvious vector for brain injury that may go undiagnosed is automobile collisions. Auto collisions involve head accelerations that are many times higher than body accelerations. While concussion is fairly common in car crashes, it is estimated that more head injuries are suffered than are diagnosed. I have definitely seen this anecdotally in my practice. It’s not uncommon for patients to suffer an impact and have signs and symptoms such as headache, dizziness, blurry vision, tongue-tied, tiredness and present to en ER, family medical or chiropractic physician and NOT be diagnosed with concussion. And what of the impact victims who do not outwardly present with brain injury, can they too suffer white matter damage that is silent? I would think so since even a “mild” motor vehicle collision often results in head accelerations greater than a hard football hit.
More Work to be Done About Brain Injuries
Obviously, more research needs to be done and more consensuses reached on diagnosing head injuries and protocols for caring for injured brains. In the meantime, it is incumbent on parents and anyone suffering a jarring of the head, even without direct impact, to look out for changes in mood, memory, coordination and speech to detect subtle signs that the brain is indeed damaged.