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A Blow to the Brain
Jun 8th, 2011 Headlines

Nathan Horton, sickness the twenty-six year old right winger for the Boston Bruins, troche has a serious concussion after taking a hard hit to the head.

What exactly is a concussion? A concussion is an injury to the brain that is caused when the brain literally rattles inside the skull after a blow to the head or even the body.  Your brain is a soft organ that is surrounded by liquid and protected by a hard skull.  A bad enough hit, however, can cause your brain to crash into its own skull.

The kinds of symptoms caused by a concussion depend on the severity of the blow.  Some patients don’t have many symptoms at all. On the other hand, bad concussions can cause memory loss, severe headache, weakness, numbness, poor coordination, slurred speech, extreme drowsiness, and loss of consciousness.

Many people are under the wrong assumption that you have to pass out to have a concussion.  In fact, many people with a concussion don’t pass out.  The American Academy of Neurology developed a grading system.  With Grade 1, someone has brief confusion, lasting less than 15 minutes and has no loss of consciousness.  With Grade 2, the patient has confusion or other neurological symptoms that last more than 15 minutes, but also has no loss of consciousness.  Anyone who passes out, however, is automatically considered a Grade 3 and warrants immediate medical evaluation.

As for Horton, the Bruins have not officially said what type of concussion he had. Press reports are claiming he hit his head on the ice and appeared to lose consciousness. This loss of consciousness would automatically make it a Grade 3.  He stayed down for several minutes after he was hit, and was taken off the ice on a stretcher. Horton was admitted to Massachusetts General Hospital where he stayed overnight for observation and left the next morning. One of his teammates, Boston forward Milan Lucic, said Horton had sent him a birthday wish through text message yesterday. On the positive side, Horton felt well enough to remember his teammate’s birthday.

If an athlete has a concussion, can they return to the game? If it’s a Grade 1, an athlete will be observed and if his or her symptoms completely resolve, they may be able to rejoin the game.  With a Grade 2, the athlete is taken out of the game with close medical follow-up and rest. These athletes are generally not allowed to return to the sport until they are two weeks symptom free.  Athletes with a Grade 3 are taken to an emergency room for further evaluation, which usually includes brain scans to rule out bleeding. Unfortunately, the Bruins have already announced that Nathan Horton will miss the remainder of the Stanley Cup playoffs.

It is too soon to say what Horton’s longterm recovery will be like.

Some people feel normal again in a few hours, while others have symptoms for weeks or months. Resting the brain is of upmost importance. It is necessary to avoid alcohol, and to use the pain medication as directed by their doctor.  Most importantly, you must do all you can to avoid a second concussion.  A repeat concussion, before the first has healed, can cause significant problems, including brain swelling and death in a small percentage of patients.

What should people do to avoid concussions? While it may seem like common sense, it would be safe to avoid anything that might cause a blow to the head.  For young children, take precautions in your house to protect them from head trauma.  If you’re an athlete, wear a helmet and protective equipment when you play sports, and when riding a bike, motorcycle, scooter, snowmobile, or ATV.  As you can see in Nathan Horton’s case, however, helmets don’t necessarily protect you against concussions.  They do reduce the risk of skull fracture.  In addition, make sure to wear a seat belt every time you’re in a car, whether you are the one driving it or are the passenger.

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