The effects of concussions among pedestrian accidents

Brain Concussion

Pedestrian accidents, as in the question, often result in brain concussion in the victims. The effects of concussions among pedestrian accidents ought to be studied, being a critical determinant of their health outcomes. A brain concussion, also known as a mild traumatic brain injury, can be defined variously. According to the Center for Disease Control and Prevention (CDC), a brain concussion refers to the sudden blow to or jolting of the body, which results in the movement of the brain suddenly within the skull. The brain lies within the skull, protected all around by the bones of the skull. There are many other protective mechanisms of the brain besides the skull. The other mechanisms include the buoyancy created by the cerebral-spinal fluid (CSF). While the space in the skull allows for movements of the brain therein, the rage of movement is limited to protect the various structures which rot from the brain, and which are inextensible to accommodate greater extents of movements.

After the occurrence of a concussion, a lot of changes take place. The brain, given its delicate structure, is particularly prone to changes after traumatic forces on the head of areas around the neck. Physiologically, the brain has a function that spans across the various systems of the body. The brain is one of the critical organs of the body, besides the heart and the muscles. Unlike most other body organs, a pathological change in the brain may manifest both silently, and expressly visibly accidents (Beck LF, 2017). Both of these categories of signs and symptoms should be keenly isolated at the examination of the affected persons. With this, the subsequent management of the patients is much better, with more promising outcomes.

Considering the effects of accidents, patients may report post-concussion with various effects. The effects can either be physical or invisible. The physical effects can be appreciated, while the silent, invisible ones are largely based on a clinical understanding with the anatomy of the involved parts. The identification of these categories of signs and symptoms is a key aspect of the management of the patients reporting post-concussion. While the physical effects such as deformities can be appreciated, the invisible signs must not be ignored. The progression of the signs and symptoms follows in a sequence as determined by the structural and functional design of type brain, and the traumatic effects of an accident.

One of the physical and visible effects of a traumatic pedestrian accident is whiplash. The injury occurs in the neck area, mostly due to a forceful, sudden back and forth movement involving the neck. The anatomical location and structure of the neck put in at the risk of developing this kind of injury (Ciuffreda KJ, 2018). As such, accident injuries involving the head and neck should be evaluated for effects possibly resulting from this injury type. The movement causes a strain on the neck, which could additionally cause other injuries around the same area.

Each of the signs and symptoms of a brain concussion has an anatomical route of cause. The structural changes that come with a traumatic event lead to a sequence of maladaptive changes by the brain. Through these changes, the brain attempts to maintain normal functions. With this come, secondary effects that could last for hours or even years. Part of the major changes that come with traumatic pathologies of the brain in mild traumatic injuries is the neurotransmission functions. The brain changes hence impair the coordinative roles of the brain, according to the pathology in question, setting the body into an uncontrolled mode (Padula WV, 2017). The resulting state is largely similar to a sleeping mode, which means the body undergoes a slowdown, hence the symptoms like dizziness. The kind of effects is related to the trauma result from impaired cerebral blood flow, which causes metabolic and anatomical changes in the brain. In this way, the said symptoms set in and manifest either invisibly or physically.

The recognition of these symptoms is key in management. Examinations eliciting the changes form the foundation for comprehensive care. The required medical attention depends on the needs identified from the signs and symptoms, as seen in the patients. It is hence important to note that the failure to note these changes will probably mean the brain further undergoes maladaptation, which essentially worsens the ultimate outcomes of the given care. Longer durations of the metabolic changes, for example, will lead to cellular necrosis. With the resulting edema, the brain outgrows the available intracranial space, hence leading to maladaptation like midline shifts. Further progression of these changes, if not identified and clinically corrected, would ultimately lead to herniation, such as tonsillar herniation, which can result in cardiorespiratory arrest and death.

The resulting compensatory changes in the brain following uncorrected brain changes form the basis of several complications. The complications affect all the body parts, but largely have a direct impact on the visual, auditory, and body balance systems. The balance and auditory effects, just like the discussed visual effects, resulting from the involvement of the brain parts responsible for their functionality (Jiang P, 2017). As a result, the signs and symptoms of vertigo, headaches, cognitive effects, disequilibrium, and dizziness set in. The neurotransmission slowdown results in symptoms such as dizziness.  The loss of coordinative functions of the brain causes such. Headaches, however, result from the inflammatory changes, as well as the metabolic changes, in addition to the pressure changes inside the cranial cavity. Cognitive loss root from metabolic changes, as well as the anatomical changes in the brain.

Some of the effects, especially the vestibular functions of the brain, further relate with body structures uniquely. With the impaired vestibular roles of the brain through the vestibular component of the vestibulocochlear nerve, the body balance is lost. As such, the persons lose their ability to maintain their posture as required. In this way, the body may gain further physical deformities of body parts such as the spine, especially in long-standing disequilibrium. On the same note, pre-existing deformities such ass scoliosis may worsen the effects related to balance. Due to the loss of balance, pre-existing deformities cause further difficulty in maintaining balanced postures. The deformities have the effects of changing the body’s center of gravity, and with the balance effects of concussion, the pre-existing deformities can worsen the situation.

Due to the disruption of these pathways at the brain, secondary to the traumatic compromise of brain functions, the various organs associated with the brain directly, such as the eye, occasionally lose some aspect of their functions. The result is the ocular and even vestibular symptoms of brain concussions. In many studies, it has been established that about 30% of patients with Traumatic Brain Injury report visual interruptions. Another study suggested an incidence of about 90% visual interruptions, either primarily or secondarily, following traumatic brain injuries.

In conclusion, from the discussion above, concussions are a common occurrence. More essential, however, is the fact that the approach to a patient presenting with features of a possible concussion requires a comprehensive evaluation. The history of such patients, and their physical examinations, should hence touch on all the areas that can be affected. Essentially, therefore, this calls for a multidisciplinary approach to such patients. The disciplines involved, such as ocular specialists, may need to cooperate with the ENT specialists to improve on the outcomes of treating such patients. The essence of explaining the effects of concussions, especially the correlations with various other organs, is to enhance the outcomes of treatment.

 

 

References

Beck LF, Dellinger AM, OʻNeil ME, Motor Vehicle Crash Injury Rates by Mode of Travel, United States: Using Exposure-Based Methods to Quantify Differences, American Journal of Epidemiology 2017, Vol. 166, No. 2

Bertin RJ, Berthoz A. Visuo-vestibular interaction in the reconstruction of traveled trajectories. Exp Brain Res 154 (2014), 11-21

Bronstein AM, Patel M, Arshad Q. A brief review of the clinical anatomy of the vestibular-ocular connections – how much do we know? Eye (2015) 29, 163–170

Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor © 2018 Neuro-Optometric Rehabilitation Association dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78(4):155-61

Jiang P, Chiba R, Takakusaki K, Ota J. A postural control model incorporating a multisensory inputs for maintaining a musculoskeletal model in a stance posture. Journal. Advanced Robotics Volume 31, 2017: 1-2: 55-67

Padula WV, Capo-Aponte JE, Padula WV, Singman EL & Jenness J (2017) The consequence of spatial visual processing dysfunction caused by traumatic brain injury (TBI), Brain Injury, 31:5, 589-600, DOI: 10.1080/02699052.2017.1291991

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