#21 October Edition - What Actually Happens to Your Brain During a Concussion?

Hi everyone!

Last month, we talked about how early management makes all the difference after a concussion.

But what actually happens inside the brain when someone gets concussed?

A concussion isn’t just a “bump” or “shake.” It sets off a rapid, complex series of events — often called the concussion cascade — that affects brain chemistry, energy levels, and communication between neurons.

Here’s a closer look at what your brain goes through, step by step 👇

⚡️ Step 1: The Impact

A hit to the head — or even a whiplash-style force — causes the brain to move quickly inside the skull.

This stretching and shearing of brain cells (especially long nerve fibers called axons) disrupts their normal function almost instantly.

🌊 Step 2: Ionic Chaos

Like a short-circuited power grid, the injury causes a flood of potassium out, and calcium and sodium in.

At the same time, glutamate, an excitatory brain chemical, is released in excess — overstimulating neurons and worsening the instability.

🔋 Step 3: Energy Crisis

Your brain tries to fix the chaos, but it needs a huge amount of energy (ATP) to do so.

The problem? Blood flow to the brain actually drops after a concussion.

This mismatch between energy demand and supply leads to a “metabolic crisis” — like trying to charge your phone on 1% with a broken charger.

🔥 Step 4: Inflammation

The brain’s immune cells (microglia) activate and release inflammatory signals.

While this response is meant to protect the brain, chronic or excessive inflammation can delay recovery and contribute to longer-lasting symptoms.Lorem Ipsum!

🧩 Step 5: Disrupted Communication

With neurons struggling to function, brain circuits can’t communicate properly.

This is why symptoms like brain fog, poor focus, light sensitivity, or mood swings often appear — and why the brain is more vulnerable to a second injury during this window.

🧠 Persistent Concussion Symptoms:

Why Do Some People Take Longer to Recover?

For some, symptoms fade quickly.

For others, they linger for weeks or even months — a condition known as Persistent Post-Concussion Symptoms (PPCS).

Researchers have identified several consistent risk factors:

🚩 Key Risk Factors

• Mental health history (anxiety, depression, trauma, personality disorders)

• Female sex

• Previous concussions

• History of migraines or headaches

• Older age (especially middle-aged adults and teens)

• High symptom burden at time of injury

• Injury mechanism (e.g., motor vehicle accidents)

  ➕ Other Contributing Factors

• Learning differences like ADHD or dyslexia

• High anxiety sensitivity or pain catastrophizing

• Lack of early rehab or active recovery

• Social factors like litigation stress or rural location

Our understanding of the brain and concussions has come a long way in the last 10 years.

It’s still one of the hardest injuries to rehabilitate — not because the brain can’t heal, but because the symptoms are often invisible, unpredictable, and deeply personal.

That’s why education matters. That’s why early care matters.

And that’s why I’ll keep sharing these insights each month — to help you or someone you care about navigate recovery with more clarity and confidence.

If you know someone who’s recovering from a concussion — or supporting someone who is — please share this newsletter with them.

You never know who might need it.

Until next time,

Kosta Ikonomou