It’s mind-blowing to know that even a small bump can cause a life-threatening brain injury
Tracey Champagne tells her story like it happened yesterday. One morning, a relative a few doors down was cooking breakfast when she banged her head on a cupboard door. Not long after, she arrived at Champagne’s home feeling slightly off and a little dizzy. Champagne watched her for a while until her mother, worried about a concussion, rushed her to the hospital. It was the last time tracey ever saw her relative fully cognitive again. She died a few weeks later, at the age of 33. Doctors told her family she had a brain aneurysm—which might have stayed put for years before becoming an issue—that erupted when she hit her head on the door.
It’s unfathomable to think how a small bump to the head can have such a devastating consequence.
While we can’t spend our lives obsessing over such extreme outcomes, Tracey’s story is a reminder to exercise caution— whether we’re motorbiking in Greece, playing a little football in England, or simply cooking a meal in our own home. Let actress Natasha Richardson’s fatal story be a warning: we need to be aware of the signs and symptoms of concussion and possible brain injury.
According to the Brain Injury Association of Canada, head injuries are more common than you might think
11,000 people die each year and more than 6,000 are left permanently disabled after a traumatic brain injury. It’s “the number-one killer of males under 35,” says executive director Harry Zarins, and these numbers don’t include the tens of thousands of people who get concussions every year. (Concussions are defined as mild traumatic brain injuries where bleeding in the brain is absent. Though not life-threatening, they can impair brain function and there’s growing concern over how much permanent damage they do.)
While there are several types of head traumas, it’s the degree of injury that is of most concern,
says Dr. Tarek Razek, who has seen everything from minor to severe head injuries as chief of trauma at McGill University Health Centre in Montreal. If your head gets squashed by a truck, he admits not much can be done. but many injuries, including ones that end fatally, begin as minor blows that become serious when too much time passes from the moment of impact to when proper treatment is initiated. The sooner a patient gets to “definitive care,” says Razek—a trauma centre with the right diagnostic equipment such as an MRI machine and neurosurgeons—the better chance he has of not only surviving, but also of not sustaining permanent damage.
Why is time important? Because with many head traumas it’s not the impact that causes the damage but the ‘secondary injury’ done to the brain: the intense pressure put on it by any internal bleeding or swelling after a hit to the head. Luckily, our brains are protected by hard skulls; unluckily, the skull can’t expand to accommodate fluid buildup. “Any tissue you injure will swell,” says Razek. “It breaks down a little and accumulates fluid as part of the healing process. the brain does the same thing.” Moreover, even minor traumas can lacerate, rupture or shear blood vessels in the skull or brain, causing bleeding either within or around it, and with disasterous results. When blood accumulates in the skull cavity, for example, it pushes on the brain, and in severe cases surgery may be needed to remove a section of the skull so the brain can expand out, instead of down into the brain stem.
One danger to watch for is ‘the lucid interval’ following an injury (also known as the ‘talk and die’ syndrome).
That’s when someone takes a hit to the head that may appear harmless, has minor confusion or a momentary loss of consciousness, then feels fine for a period of time.
If you or someone you’re with gets hit on the head, stay alert for symptoms of serious injury, not just minutes later but also in the hours and days to come. Look for signs of confusion, and do simple checks for motor, verbal and eye responsiveness. if someone can’t answer simple commands, such as “give me a thumbs-up” or respond appropriately to a pinch on the arm, seek medical attention. And always do so with any loss of consciousness or memory of the incident.
What can we learn from this? Pro- tecting our heads is important. Car accidents are the leading cause of head traumas and seat belts greatly reduce their severity. And wear a helmet, says razek, who has seen devastating disabilities caused by simple spills from bikes and in-line skates. Use a helmet whenever speed is involved and always have kids wear one. see the Canadian standards association’s guidelines for info on the best new helmets: csa. ca/news/announcements. Then there’s his own experience. I had a horrific bike crash when I was in university. A van went through a red [light] and just clocked me. I didn’t break any- thing, but my helmet was smashed in two.” What would’ve happened if he hadn’t been wearing one? “I’d be doing something very different right now—like eating [with] a straw.”
NOTE: this is a guidline only. Always get individualized advice from a qualified health professional. For more information, visit the Brain Injury Association of Canada at biacaclc.ca; and the CSA at csasafetytips.com has info on helmet use.