Watch Your Head: Helmets Protect More than You Think
Brain.com/John D. MacArthur

If you are between the ages of 15 and 24 and drive a motor vehicle, ride a bicycle, or play sports, then you are at the top of the risk list for brain injury. Men are nearly twice as likely as women to injure their brains, but all of us are quite vulnerable to brain damage — and prevention is the only cure. Every 15 seconds someone in the United States suffers a traumatic brain injury (TBI). Of the 1,000,000 people treated in hospital emergency rooms each year, 50,000 die and 80,000 become permanently disabled because of TBI. This is higher than the combined incidence of Alzheimer’s, Parkinson’s, and Multiple Sclerosis. One out of every fifty Americans is currently living with disabilities from TBI.

TBI is significantly underdiagnosed and has no cure, therefore prevention is paramount. Helmets, seat belts, air bags, and car seats have been proven to reduce TBI incidents and death. Bicyclists who wear helmets can lessen their risk by 85%, and when motorcyclists wear helmets, mortality is reduced by 38%. While vehicle crashes are the leading cause of brain injury — followed by violence, (mostly from firearms) and falls — an estimated 300,000 cases of TBI occur each year from sports and recreation accidents. Most are considered mild and appear to be trivial blows to the head, but it turns out that the consequences are not so mild and often lead to deep and prolonged impairments of the brain.

Mild Traumatic Brain Injury
You don’t have to be knocked out in order to sustain a brain injury. Mild traumatic brain injury (MTBI), also known as concussion, is becoming a serious public health problem. Unfortunately, the area of the head most vulnerable to injury is also where the most fragile and crucial region of the brain is located. Behind your forehead lies your prefrontal cortex, the center of your higher-order “executive functions,” as well as home to your social awareness and moral conscience. Injury to the prefrontal cortex can affect your most human qualities: the ability to process information and solve problems; to concentrate, remember, and learn. Damage here can lead to personality changes that manifest in impulsive and socially inappropriate behavior, depression, and violence.

Your Braincase
Marvel of engineering that it is, the human skull is no match for the kinds of insults it faces this century. Collisions with metal or asphalt, goalposts or noggins, create forces that can severely damage the brain’s tender protoplasm and disrupt its intricate circuitry. Even the apparently innocent heading of soccer balls has cerebral consequences. Like personal tectonic plates, your braincase is composed of eight unique cranial bones. On either side of your skull, layers of material help protect your brain from normal wear and tear. On the outside are muscle, skin, and hair; on the inside, connective tissue and fibrous membranes.

Within your skull, your gelatinous brain floats in a sea of cerebrospinal fluid that bathes and supports this precious organ, while acting as a shock absorber during rapid head movements. Although the outer surface of the skull is smooth, parts of its inner surface are rough and jagged and can cause significant damage in acceleration/deceleration, or “closed head injuries.” In this type of injury there may be no external damage, but because the head abruptly stops after being in motion, the brain rebounds back and forth against the skull’s interior bony structures. This trauma initiates a cycle of biochemical events responsible for the major long-term deficits associated with brain injury. Shaken Baby Syndrome is a closed head injury. An estimated 50,000 cases of this abuse occur each year in the United States. One in four shaken babies dies after their brains are severely injured from violent shaking and twisting.

Helmets — Your Brain’s Best Friend Children suffer 50,000 bicycle-related brain injuries in the U.S. each year, and more than 400 of them die as a result. Motorcycle riding has 16 times the death rate per mile compared to automobiles. Riders without helmets are 10 times more likely to need brain surgery due to head injury. A 1997 report by the National Highway Traffic Safety Administration showed that helmets do not restrict hearing, nor do motorcyclists have trouble compensating for any restriction of vision. Helmets would also prevent brain damage in water and winter sports. Head injuries account for 29% of all jet-ski injuries and 15% of sledding accidents. They are the leading cause of death and serious injury among skiers and snowboarders, mostly from collisions with a tree. Many of these head injuries could be prevented if helmets were worn.

The Dangers of Cumulative Brain Damage After one brain injury, your risk for a second injury is three times greater — and eight times greater for subsequent injuries. One of the biggest problems with sports-related MTBI is the cognitive and neurological effect of repeated minor head injuries. Almost every concussion causes some damage to the brain, and the damage from successive concussions is cumulative. According to Swaid Swaid, M.D., a neurosurgeon at HealthSouth Medical Center, the additional risks from a series of concussions include premature senility, Alzheimer’s Disease, and Parkinson’s Disease. Regardless of severity, a second brain injury can be life-threatening if experienced within hours or days of a first.

New findings by researchers at the University of Pennsylvania support previous epidemiological links between a single episode of brain trauma and the development of Alzheimer’s Disease later in life. In animal studies, scientists induced brain injury without direct impact, similar to what humans often experience in automobile accidents. Analysis of damaged brain cells revealed extensive amyloid beta and tau accumulation, as well as plaque formation — all typical findings in Alzheimer’s Disease. These changes were evident as early as 3 to 10 days after the injury.

Source: Journal of Neuropathology and Experimental Neurology
1999;58:982-92)

This article is reprinted with permission from www.brain.com a resource for information, education and products related to the brain.

For more information: The Violence and Brain Injury Institute - HeadSmart Schools program for children and adults

JAMA September 8, 1999 Journal of the American Medical Association issue with five reports on TBI

..............................

Premier Outlook is a publication of ResCare Premier. The views and opinions expressed in this publication, outside of the editorial and the About us…. sections, are not necessarily the views and opinions of the publisher and staff of Premier Outlook. The materials presented herein are a service and for information purposes only. We have not screened each individual or organization that appears in this publication. The appearance of an individual or organization in this publication is not intended as an endorsement. We urge all readers of this publication to conduct their own investigation of the products and services identified herein. Premier Outlook reserves the right to refuse or edit articles and publications submitted for consideration. If you would like to comment on our publication, inform us of mistakes or dead links, or suggest relevant links or topics, we would be pleased to hear from you at: editor@premieroutlook.com.

Permission to duplicate, reprint, or electronically reproduce any document in part or in its entirety may be obtained by written consent from the editors.

Copyright © 2002 Premier Outlook. All rights reserved