Los Angeles resident Wilson Crasta awoke to find a spider in the corner of his bedroom ceiling. Crasta loathes spiders and rarely missed an opportunity to squish one. With his prey in sight, he rolled up a magazine and climbed onto a chair. As he reached back for the kill, one of the chair's legs snapped, causing him to fall backward and hit his head on the floor.
When Crasta came to, he found himself surrounded by firemen and paramedics stabilizing him for a trip to the emergency room. His war on arachnids landed him in the hospital as one of the 1 million Americans treated for a traumatic brain injury each year.
"They were trying to put the neck brace on me, and I flipped out because I had no idea who they were or what had just happened," Crasta said. "I started struggling with them -- I think I even kicked one of them in the face -- and I didn't really calm down until I saw my roommate in the corner telling me to relax. Needless to say, they strapped me down pretty tightly in the ambulance."
According to the Brain Injury Association, someone in the U.S. sustains a traumatic brain injury every 15 seconds. Vehicle crashes, falls, and sports injuries are the three leading causes. These injuries can leave victims with temporary or permanent cognitive and emotional problems, including memory loss, speech impairments, fatigue, and impulsive behavior.
The recent concussion-related problems of NFL quarterbacks Steve Young and Troy Aikman have brought more media attention to traumatic brain injuries. Both players decided to continue their careers despite warnings about their elevated risk of sustaining permanent brain damage.
"What people always want to know is how many concussions is too many," says San Diego neurologist John Rosenberg, MD. "From the neuropsychological data that I've examined, there's no doubt that repetitive concussions eventually lead to permanent brain injuries. You may not see symptoms initially, yet chances are good that they'll come back later in life to bite you."
Compounding the problem are data showing that the risk of a second brain injury triples after an initial injury. After a second injury, the risk of a third becomes eight times greater.
While most men don't face the prospect of being blindsided by a 250-pound linebacker, men are at greater risk than women for incurring brain injuries. Men have higher rates of car accidents and greater participation in contact sports like football, basketball, or hockey. In the four states that reported deaths resulting from sports-related brain injuries between 1990 and 1993, the number of fatal brain injuries ranged from 2.1 to 5.5 deaths per 100,000 people, according to the U.S. Centers for Disease Control and Prevention. Those numbers should make athletes and spectators take notice and find out what to do during a brain-injury emergency.
Making the Grade
The first step is to determine the "grade" of the head injury. According to Rosenberg, the American Academy of Neurology (AAN) defines three grades of concussions. A grade-one concussion, commonly referred to as "getting your bell rung," doesn't result in a loss of consciousness but does involve the haziness and disorientation normally associated with head injuries. A grade-two concussion has similar symptoms but lasts beyond 15 minutes. A grade-three concussion is determined by a loss of consciousness.
Rosenberg explains that an athlete can return to competition on the day of a grade-one concussion, while a grade-two concussion can keep a player out of play for up to two weeks. It usually takes about a month to fully recover from a grade-three concussion.
Injury prevention for athletes involves wearing a helmet, especially in fast-paced or contact sports like skiing, biking, or hockey. The Bicycle Helmet Safety Institute estimates that helmets can reduce the risk of serious injury by up to 85% in all age groups.
Finally, Dr. Rosenberg probably has the best recommendation for avoiding accidental head injuries: common sense.
"Maybe instead of climbing on a chair, he [Mr. Crasta] might consider using a broom the next time he wants to kill a spider," Rosenberg said.