Traumatic Brain Injury
"I would advise kids not to play any sports, such as tackle football, where they are exposed to repeated blows to the head."
Ann McKee, M.D. Director of Boston University's CTE Clinic
​Brain injury is poorly understood and broadly misunderstood. As a direct consequence, many who suffer the symptoms of brain injury have no idea why.
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Brain injury occurs on a spectrum from:
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The most grossly misunderstood portion of this spectrum is from silent injury to severely symptomatic, closed-head brain injury.​ So, allow me to share a bit of what I know.
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Sub-concussive insults (insults to the brain that don't meet full concussion criteria)​ to the brain can have: "Equal or greater g-forces to the brain and cause equal or greater damage to the brain" (Ann McKee, M.D.). For this reason, researchers at Boston University are now more concerned about sub-concussive insults to the brain than concussions and have compared them to the portion of the iceberg under the water.
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Why? Because they are asymptomatic (symptom free), they happen vastly more frequently and, as you read above, can cause equal or greater injury to the brain.
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This is of paramount importance because brain injury is cumulative over your lifespan: from birth to death. When you were born blue, fell out of the high-chair at 2, the skating accident at 8, football in junior high, the car accident at 16 and all those times you hit your head on the roof of the car getting in—it all adds up. I believe this is one of the key reasons that many people can't identify where their symptoms come from and are unaware they have had an injury to the brain.
At some point, as insult layers upon insult, a threshold is crossed from silent injury to lingering symptoms that resolve with time. There is a second threshold where symptoms persist without medical intervention. And then a third threshold where symptoms are permanent, regardless of medical intervention, although there may be improvement.
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No injury
Death
"Is a concussion going to lead to CTE? No, probably not in most cases. But if you have enough concussions over a certain amount of time, yes, then I think it can lead to CTE."
Ann McKee, M.D. Director of Boston University's CTE Clinic
Did You Know?
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You don't have to have lost consciousness to have an insult to your brain.
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Symptoms may not appear for as long as 3 months after an insult.
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Helmets do not prevent concussions. They prevent you from splitting your head open.
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If helmets protected you from brain injury, NFL football players would not get chronic traumatic encephalopathy (CTE).
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A 5 mile-an-hour fender bender can, bio-mechanically, speaking apply 18 g's to the head and brain.
Ann McKee, M.D. Director of Boston University's CTE Clinic
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