What is a Concussion?

Everyone knows what a concussion is but nobody knows whats actually going on. I’ll break down whats going on in the brain metabolically post concussion.

We all have a general idea of what a concussion looks like

  • Headache
  • Dizziness
  • Nausea
  • Cognitive deficits
  • List goes on

The point of this is not to help you assess a concussion, but rather, to understand whats happening so that recovery can be optimized.

Biomechanical Trauma Post Concussion

Glutamate (an excitatory amino acid) binds with N-methyl-D-aspartate (NMDA). This causes depolarization of the neuron

This depolarization then causes potassium to leave the cell in high volume. As potassium leaves, this allows calcium to enter

Calcium in the neuron impairs neuro-connectivity

This graph depicts the the flow of potassium out and calcium in when a concussion occurs

Sodium-Potassium Pump Issues

This rapid flow of calcium and potassium taxes the sodium-potassium pump greatly. This overworks the pump leading to a larger need for ATP as ATP is now in a deficit

This triggers a dramatic increase in glucose metabolism. This increase in metabolism occurs in a setting where there is decreased cerebral blood flow

Sodium potassium pump issues with a concussion

Oxidative Stress

Now we have oxidative stress that further complicates the issue as glucose is being consumed at an advanced rate

The net negative of glucose in the system triggers an energy crisis

    Magnesium Deficiency

    The energy crisis is what causes the increase in vulnerability to the head post concussion. In addition to glucose depletion, magnesium is depleted from the system for 4 days

    Magnesium improves motor function so you can see how the absence leads to textbook concussion symptoms (balance and coordination issues, loss of fine skills acutely)

    Low levels of magnesium unblock NMDA which then causes a greater influx of calcium (not good). It takes 2 days for calcium levels to peak and 4 days to return to normal

    Neurons

    Neurons have the ability to heal themselves during this 4 day period assuming there is no additional trauma. This is why protection from additional trauma is key for head injuries early on

    A 2nd traumatic brain injury that occurs before the first one has healed can lead to permanent neuron death (real bad). This is a huge concern for athletes

    If you can take away one thing from this let it be the following:


    A concussion is a metabolic condition of the brain that needs 4 days minimally to properly heal from

    To learn more about the correlation between a concussion and CTE/Alzheimer’s Disease, click here