Traumatic Brain Injury & Concussions
I became interested in traumatic brain injury after seeing firsthand how disruptive a concussion can be.
A concussion is a form of mild traumatic brain injury (TBI). It can result from a blow or jolt to the head—or a force to the body that causes the brain to move rapidly inside the skull. Symptoms can affect thinking, memory, balance, mood, sleep, vision, and physical well-being.
Most people recover, often within days or weeks. Current guidance generally favors a gradual return to normal activity after a brief period of relative rest, rather than prolonged complete rest.
I am also interested in the longer-term question: Can head injuries increase the risk of cognitive decline or dementia later in life? Moderate or severe TBI and repeated head impacts have been associated with increased risk. A single uncomplicated concussion, however, should not be assumed to cause Alzheimer’s disease or dementia.
Recognizing a Concussion
A person does not have to lose consciousness to have a concussion. Symptoms may include headache, dizziness, nausea, balance problems, sensitivity to light or noise, blurred vision, fatigue, difficulty concentrating, memory problems, irritability, and changes in sleep.
Emergency warning signs include a worsening severe headache, repeated vomiting, seizures, increasing confusion, weakness or numbness, slurred speech, inability to stay awake, unequal pupils, or loss of consciousness.
Someone with a suspected concussion should be removed from sports or other activities where another head injury could occur and medically evaluated.
Recovery & Return to Activity
Concussion treatment has changed. Rather than prolonged complete rest, current guidance generally recommends relative rest for the first day or two followed by a gradual return to normal activity as tolerated.
Light activity such as walking can often begin fairly early if it does not significantly worsen symptoms. School, work, exercise, and other activities can then be increased gradually.
An athlete with a suspected concussion should not return to play the same day. Return to sports should be gradual and follow appropriate medical guidance.
Most people improve substantially within days or weeks. Persistent symptoms—such as headaches, dizziness, sleep problems, vision difficulties, or exercise intolerance—deserve further evaluation.
Repeated Head Injuries & CTE
Repeated concussions and repeated head impacts are a greater concern, particularly among people with long-term exposure to collision sports or other repeated head trauma.
Chronic traumatic encephalopathy (CTE) is a degenerative brain disease associated with repeated head impacts. It has been identified after death in some former athletes and others with substantial exposure.
Important questions remain about how common CTE is and why some people with repeated head impacts develop it while others do not. At present, CTE can be definitively diagnosed only by examining brain tissue after death.
TBI & Dementia Risk
Research has found an association between moderate or severe traumatic brain injury and an increased risk of cognitive impairment and dementia later in life. Risk also appears to increase with repeated TBIs.
The relationship is less clear after a single uncomplicated concussion.
An increased risk is not a prediction of what will happen to an individual. Age, genetics, cardiovascular and metabolic health, and many other factors also influence dementia risk.
The practical message is straightforward: prevent repeated head injuries whenever possible and allow the brain adequate time to recover after a concussion.
Supplements & Nutrition
Researchers are studying whether nutrition and certain supplements may help the brain recover after concussion or traumatic brain injury.
Omega-3 fatty acids, particularly DHA, are of special interest because DHA is an important component of brain-cell membranes. Vitamin D, magnesium, riboflavin, melatonin, and antioxidants are also being investigated.
The evidence remains preliminary, however, and none of these supplements has been established as a treatment for concussion.
For now, maintaining good nutrition and correcting documented deficiencies makes sense, while supplements remain an interesting area of ongoing research.
Protecting the Brain
Not every head injury can be prevented, but risks can be reduced through appropriate helmets and protective equipment, seat belts, sports concussion protocols, and avoiding another head injury before recovery.
For older adults, fall prevention is particularly important. Strength and balance training, reviewing medications that may contribute to dizziness, correcting vision problems, and reducing hazards in the home can all help.
The goal is simple: protect the brain from the injuries we can prevent and take the injuries that do occur seriously.
Learn More
Practical information about concussion symptoms, recovery, return to school and sports, prevention, and when to seek medical care.
Information and support covering concussion, recovery, rehabilitation, persistent symptoms, and living with brain injury.
An overview of what researchers know about traumatic brain injury, repeated head injuries, cognitive decline, and dementia.