Brain Power

December 22, 2021

The topic of brain injury has become a hot button issue over the last decade.  With more and more research being conducted regarding concussions and CTE (chronic traumatic encephalopathy) in sports like professional football, the public has become more interested in how to keep their brain’s healthy as they age.  While avoiding falls is of paramount importance, what can be done if a head injury or concussion is sustained after a fall has already occurred?  In order to understand what needs to be done, one needs to understand what actually occurs to your brain when you hit your head.  

The brain is suspended inside of your skull with cerebrospinal fluid, or CSF for short.  You can think this as if your brain is floating like buoy in water.  When you fall down or hit your head, your brain has some room to move around inside of your skull, resulting in actual impact of your brain against the inside of your skull if the force is strong enough.  This is termed a “coup – contra coup injury” to the brain, meaning your brain first impacts against one side of your skull, then rebounds and hits another side of your skull.  Which side of your head you hit and in what direction will determine what parts of your brain become injured.

For example, if someone were to fall backwards off of a ladder and hit the back of their head, the back of their brain (more specifically, their occipital lobe) would hit the back of their skull first.  The occipital lobe is in charge of vision and coordinating eye movement.  This means that symptoms of this concussion could include dizziness or nausea related to eye movement, including turning the head, reading a book or trying to focus on a screen for long periods.  

So what should we do if we DO end up hitting our heads and begin feeling unwell?  The first thing that needs to be done if we hit our heads very hard is determine if it is a medical emergency.  Symptoms like quick onset of a headache that is often referred to as “the worst headache of my life” could indicate a brain bleed and an ambulance should be called immediately.  For non-emergent cases, you should contact your physician to be screened for a concussion.  If a concussion has been sustained, rehabilitation with a physical therapist for post concussion management is paramount to help your symptoms resolve quickly.