Shaken Brain: The science, care, and treatment of concussion

CONCUSSION IS GROWING in importance as an issue as more research reveals the dangers of repeated injury. In Shaken Brain, Elizabeth Sandel – a physician with three decades’ experience studying and treating concussion – details what happens in the human brain when it is injured, and how medical providers can help.

Sport has been a key driver on this front, with more concussion protocols being introduced at the professional level. But it’s pointed out that damage often occurs earlier in an athlete’s sporting career, at junior levels where such measures are not adhered to.

A recent high-profile case featured professional American football player Aaron Hernandez, who was tried and convicted of murder. He committed suicide in prison at 27, and at the request of his family, his brain was released to Boston University to be studied for signs of chronic traumatic encephalopathy (CTE), a progressive degenerative disease found in people who have had a severe blow or repeated blows to the head, including football players who suffer concussions.

CTE results in such things as poor judgment, lack of impulse control, aggression, anger, paranoia and emotional volatility. The researchers diagnosed Hernandez with CTE, described his brain as a classic case of the pathology, and suggested that this may explain some of his criminal acts.

Of course, it’s not just sport. Head injuries can result from vehicle collisions, incidents at work and from everyday activities – think children falling over. In Shaken Brain, Sandel looks at the specific groups of people with a higher-than-normal chance of concussion, such as the elderly, victims of domestic violence, the homeless and the young.

She also examines prevention as a public health issue to address it on an institutional level. Her work features stories from a wide range of patients, to provide an insight into prevention, diagnosis, and treatment.