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.
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 neuroconnectivity

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