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

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

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