Why Traumatic Brain Injuries Increase Second-Hit Risk
In a recent observation by several scientist, they assume that there is a reason why traumatic brain injuries increase second-hit risk. On September 25, quarterback Tua Tagovailoa of the Miami Dolphins got the pass off, but he was knocked down.
As he tried to jog it off, people saw him shake his head and fall down. After getting checked out by a doctor, he went back into the game against the Buffalo Bills, even though his coach later said he had hurt his back.
Four days later, Tagovailoa, who is 24 years old, got hit again in a game against the Cincinnati Bengals. This time, he was taken off the field on a stretcher with what turned out to be a concussion.
Many people think that Tagovailoa got a concussion or mild traumatic brain injuryfrom the first hit, since he started shaking his head and wobbling afterward. If those were signs of a head injury, that first hit could have set him up for an even worse brain injury a few days later.
According to Kristen Dams-O’Connor, a neuropsychologist and director of the Brain Injury Research Center at the Icahn School of Medicine at Mount Sinai in New York City:
The sciencetells us that yes, a person who is still recovering from a concussion is at an elevated risk for sustaining another concussion.- Kristen Dams-O’Connor, a neuropsychologist and director of the Brain Injury Research Center at the Icahn School of Medicine at Mount Sinai in New York City
When the soft brain hits the hard skull after a blow to the head, it starts a chain reaction of changes. Some nerve cells work too much, inflammationstarts, and the way blood flows changes. Dams-O'Connor says that these brain changes and how they relate to concussion symptoms can happen over hours or days and are hard to measure quickly.
This makes it hard to tell if someone has a concussion. Clinicians often have to rely on what their patients say about how they feel. Professional athletes might not want to get those symptoms if it means they will have to stay out of action.
Other signs can indicate a concussion, such as a person’s gait or pupil dilation. “As clinicians, we are often triangulating multiple sources of information to make that call - was this or was this not a concussion?” Dams-O’Connor says. The scientific uncertainty in that call should lead clinicians to err on the side of caution, she says.
After a traumatic brain injury, recuperation is crucial. “It’s much worse when an individual isn’t given the proper time to rest and recover and gets a second impact in a close period of time,” says Daniel Daneshvar, a brain injury medicine doctor and neuroscientist at Mass General Brigham in Boston and Harvard Medical School.
Researchers have seen signs in the brains of mice that were hit twice close together that the damage was worse and it took longer to heal. For athletes, this weakness comes in part from the symptoms of a concussion. Slower reaction times, dizziness, and double vision make it hard for a quarterback to avoid being tackled and see opponents coming from the side. These symptoms can cause more damage to the head and body as a whole.
The NFL and the NFL Players Association said in a joint statement that they are looking into whether their concussion protocols were followed in this case. Tagovailoa may have been able to play again in that first game because his stumbling was thought to be caused by a back injury and not a brain injury, which may or may not have been true. The NFL and NFLPA are thinking about changing the rules so that a player is taken out of a game for any kind of obvious motor instability.
For now, Tagovailoa is going through the steps in the concussion protocol to get better. Tagovailoa thanked his team, friends, family, and everyone else who has helped him through a post on social media on September 30. "I'm feeling much better and am concentrating on getting better so I can play with my team again," he wrote.