Véronique, 54, Canadian. For over a year, she has suffered from a significant drop in energy, fatigue, sleep and attention disorders, memory loss. Her GP diagnoses depression in which she does not believe. She consults a psychotherapist who also doubts the diagnosis. During the interviews, the therapist learns that Véronique is doing judo. She is a black belt and competes in this combat sport which involves projections on the ground. The possibility of concussion sequelae is then raised and confirmed by neuropsychological tests. For Dr Dave Ellemberg (neuropsychologist at CHU Sainte Justine in Montreal and author of the book “Concussions in sport), who is subsequently to assess it, Véronique is indeed the victim of brain injuries that have gone unnoticed. also, many professional or amateur athletes, young or old, are victims of concussion without knowing it.
Storm under a skull
The term concussion is applied to a violent shake to the head or minor but repeated shaking. Under the effect of shock, the brain is moved inside the skull. The most frequent concussions are associated with contact and collision sports (football, rugby, judo skating, etc.). The shock can obviously be brutal: the brain of an athlete who suffers a violent trauma endures the same force of impact as a car launched on a brick wall at 70km / h. “But the repetition of injuries, concussion after concussion, increases the severity of the sequelae and can make them just as serious as a violent shock. If the match continues, training resumes, the next injury will be more at risk of complication than the first, says Dr. Dave Ellemberg. We must fear the more serious “second impact syndrome”, which causes an outbreak of inflammatory processes and swelling of the brain. “. Situations, given their frequency, that must be better prevented.
A silent epidemic
A Canadian study published in 2002 reported that 60% of college athletes had symptoms of concussions in a single season. Since 2011, in the United States, prevention campaigns have been organized on campuses, in stadiums to alert people to post-concussion syndrome. “If the brain is weakened from the first concussion, it has the ability to recover thanks to neuronal plasticity. But, beyond three concussions, studies show it, he will be overwhelmed, and his functioning altered, ”explains Dr. Ellemberg. In athletes, but also in the elderly who fall, babies who are “shaken”, recurrent concussions can cause permanent sequelae. From headache chronic or recurrent dizziness, psychic functioning is altered. The person has difficulty concentrating, reading a novel, remembering instructions or planning his work, even his personality can change completely, we have seen it with great boxers. The risk of Alzheimer’s disease is multiplied by ten. This is why, after a blow to the head, even seemingly innocuous, we must remain vigilant. To preserve her cerebral faculties, Véronique, the judoka, had to give up competition.
After a collision, watch out for small signs
If the athlete loses consciousness following the collision, it is obvious: he stops playing. But in 90% of cases, there is no loss of knowledge and his vigilance remains normal, which does not mean that he has had nothing. If he vomits, loses his balance, talks confusedly for a few minutes, complains of headaches (85% of cases), he must also leave the field and be supervised. In 30% of cases, symptoms appear 24 to 48 hours after the accident. Dizziness, impaired concentration or memory for a few days (even in the absence of loss of consciousness, we repeat), sensitivity to sound or light, are signs of concussion. ”. In this case, says Dave Ellemberg: “you have to withdraw the athlete from practice for a while and advise him to rest. The resumption of activity can only take place when all the symptoms have disappeared and with the agreement of the doctor. Spread the word…
The number
More than 150,000 light traumas, which does not mean trivial, occur every year in France after a fall or the head banging, in the street, at home, at school, on sports grounds …
Do not mix up…
-The concussions result from a violent shaking of the head or from slight but repeated shaking. Under the effect of shock, the brain is moved inside the skull. Examples: shocks during sports, shaken babies, the elderly who fall. They may seem harmless and yet have dramatic consequences.
-The head trauma include blows to the head which range from mild trauma not causing lesions (90 to 95% of cases) to more serious trauma responsible for cerebral hemorrhage or even very serious contusions. This is what drove Formula 1 champion Schumacher to the hospital where he had to be put into an artificial coma in an attempt to protect his brain.
Who and when to call?
When there has been loss of consciousness or when suspicious signs appear at a distance from the trauma, call 15 (samu) or 18 (fire brigade).
What should alert: confused words, vomiting, headaches that increase during the first five hours (or even for 12 hours), one pupil more dilated than the other, unilateral weakness (left arm weaker than the right for example), memories that still do not settle after 24 hours. Maybe it’s an intracranial hematoma that’s getting bigger.
What should reassure: the headache which stabilizes (including for a few days but without increasing), the balance disorders which disappear in the minutes or even the hour which follows.
