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Why Women’s Brains Are Vulnerable to Concussions

When Karen Murray’s daughter, age 9, asked for mom in the middle of the night, she sprang out of bed to see if everything was alright. The next thing she remembers is falling and slamming her head on the nightstand as her legs give way. The 44-year-old Philadelphia resident claims, “I blacked out.” I woke up a little while later and stood up, but I was unsteady and queasy. Murray experienced nausea for the following 20 minutes while her husband checked on their daughter. Murray eventually fell asleep again as the sickness subsided.

But the mother of two awoke the following morning with a severe headache. She suffered episodes of nausea and vertigo the remainder of the day. Murray called her mother, a nurse, while she waited for her son’s soccer practice to end, telling what had happened the night before and how she was still feeling “odd.” Worried that her daughter had sustained a concussion, her mother persuaded her to go to the emergency hospital.

Murray claims, “I wasn’t thinking I had a concussion.” “I’d always assumed that only occurred to football players, or after a significant event like a car crash.” However, when Murray arrived at the hospital, the ER doctor requested a CT scan, and Murray was indeed found to have a slight concussion.

Abigail Bretzin, Ph.D., a postdoctoral research scholar at the University of Pennsylvania’s Penn Injury Science Center, isn’t surprised that Murray didn’t realize her head injury may be as severe as it was at first. According to Bretzin, who studies how gender affects concussion outcomes, it hasn’t been acknowledged that concussion and traumatic brain injuries occur more frequently in women. “Men have generally been the emphasis. We also know that women’s brains may be more susceptible to concussions, despite the fact that overall, men experience more concussions than women. Knowing the causes, along with the warning signs and symptoms of a brain damage, can help you safeguard your brain for years to come.

How a concussion affects the brain?

According to Bretzin, the word “concussion” derives from a Latin word that means “strong shaking.” When you hit your head, your brain receives forces from the collision, and those forces set off a chain of events that can result in a variety of symptoms.

This neurometabolic cascade is researched by Douglas H. Smith, MD, head of Penn’s Center for Brain Injury and Repair. According to Dr. Smith, the brain can be compared to an electrical grid since it has a network of fibres running through it. The white matter, which is filled with axons—tiny fibres so little and delicate that you’d need to stack 100 of them side by side to be as thick as one human hair—is where the impulse travels from the grey matter on the outside of the brain to. The axons act as the electrical grid’s wires for the brain, carrying information from one neuron to the next so that we can read, speak, breathe, and move every muscle in our body.

However, suppose you whack your head as Murray did. According to Dr. Smith, the impact can quickly stretch those axons to the point where they rupture, breaking the valve in the process. The outcome? You may feel confused, hazy, have a slower reaction time, lose consciousness, and/or feel dizzy if too much sodium rushes into your axons and overwhelms them. Headache, confusion, dizziness, difficulty focusing, and other typical symptoms of a head injury continue because it takes some time for your brain to flush out all that extra sodium. According to Bretzin, when your brain strives to regulate itself and return to normal, you are much more vulnerable to another injury. For this reason, medical professionals advise concussion sufferers not to re-injure their brains in the weeks following a blow to the head.

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What happens after a concussion?

The good news is that the majority of concussion victims fully recover; according to Dr. Smith, roughly 80% are well. Additionally, scientists are attempting to determine precisely why the other 20% don’t fare as well. Dr. Smith cautions that even though your chances of making a full recovery after a head injury are good, getting medical help is always essential—even if you are starting to feel a little better. Because bleeding in the brain can cause those axons to enlarge and kill both the patient and you, we take head injuries very seriously and nearly always recommend a CT scan.

According to Bretzin, earlier care also aids in focusing on therapy modalities that may produce greater results. It can be challenging to identify and treat concussions because not everyone who suffers from them exhibits the same symptoms, according to the expert. However, if we can keep an eye on your symptoms, we can point you in the direction of medicines that might be able to stop a long-term effect.

Why women’s brains are more susceptible due to the “XX factor”

Fortunately, Murray’s brain had a CT scan the following day and revealed no internal bleeding. But she did experience symptoms for roughly three months. She experienced frequent headaches and discovered that staring at a computer screen or television for longer than an hour at a time made her experience severe headaches.

Smaller bodies, bigger problems

According to Angela Colantonio, Ph.D., a professor at the Rehabilitation Sciences Institute at the University of Toronto who studies traumatic brain injuries, these ongoing concussion symptoms may be related to anatomical variations between males and females that cause women to experience more severe symptoms than men and take longer to recover after a concussion. First of all, Colantonio notes that women frequently have necks that are thinner and smaller than those of men, making them more susceptible to the rotational forces that can harm the brain. Women are more than twice as likely to sustain concussions than their male counterparts. Because of these biomechanical variations, men’s stronger necks are better able to withstand head impacts that can result in concussions, according to Bretzin.

The female brain may be more susceptible to damage following a head injury due to anatomical differences within the brain, says Dr. Smith. Women’s axons generally tend to be smaller when compared to men’s. According to Dr. Smith, “we find that there is far less swelling and sodium influx in male compared to female axons when we do in vitro models—where we take human neurons and micropattern them into a human brain—and induce the same kind of rapid stretching of those axons that happens in concussion.” “The same effect pushes female axons toward poor pathways, like persistent sodium issues in the brain and more axon disconnection, whereas male axons seem to rebound.” According to researchers, the male brain is better able to withstand impact because of its larger axon size.

How estrogen fits in

Colantonio adds that hormones may also have an impact on how women recover from a head injury. In fact, studies have found a direct link between a woman’s menstrual cycle and her propensity to recover from brain damage. Women who sustain a concussion during the luteal phase of their menstrual cycle the two weeks following ovulation.when estrogen and progesterone levels are at their highest—experience worse outcomes a month later than those who sustain head injuries during the follicular stage.

According to a 2014 study. It’s interesting to note that women using oral contraceptives and women who have passed menopause did better after concussions. The pituitary gland. also known as the brain’s hormone control center, is thought to be suppressed by a head injury, according to the researchers’ theory. When hormone levels are high, the pituitary slows down, which causes symptoms to worsen and persist longer than they would if hormone levels were already low.

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The other dangers of being a woman

Then, according to Colantonio, there are correlations based on gender, “which isn’t about the biological attributes of men versus women but rather our socially constructed roles.” Consider the fact that one in three women experience intimate partner violence at some point in their lives. This is just one example of the gender-based violence that is pervasive throughout the world. According to Colantonio, “the head, face, and neck are common areas of injury,” and these wounds frequently recur.

How to avoid concussions and protect your brain?

There are certain sensible precautions you may take, according to doctors, even though you can’t completely shield yourself from potential sources of head injury.

Step 1: Consider ways to reduce your risk of falling.

The present focus of Bretzin’s study is on ways to prevent concussions from occurring in the first place. The solution, according to her, “could be as easy as avoiding some risky behaviours or using protective equipment, like a properly fitting helmet when you ride a bike.”

According to Colantonio, it’s crucial to understand that older adults make up one of the largest demographic groups who suffer concussions, making it all the more crucial to evaluate your risk of falling as you get older. Although it’s simple to think of falls as accidents, she argues that there are many things you can do to avoid them. “Things like getting enough sleep, not rushing when you get up, exercising to build balance and strength, and even wearing well-fitting shoes can go a long way toward keeping you safe.” Even more, Colantonio advises collaborating with an occupational therapist who can perform a home safety assessment, look for trip hazards, and offer design suggestions to keep you safe.

Step 2: After a head bump, consult a physician right away.

One of the most crucial things you can do, according to Bretzin, is to identify and treat a head injury as soon as you can. According to her, seeking medical attention as soon as possible after being hurt can significantly help to prevent or lessen any long-term effects. Dr. Smith concurs, noting that it’s crucial to see a specialist if you’ve been given a concussion diagnosis. “Your primary care physician may not know who to refer you to if you hit your head,” the author warns. Ask for a concussion specialist, who will be more knowledgeable about head injuries and be able to direct you to particular rehabilitation procedures and perhaps even clinical trials.

Step 3: Recognize that you can take steps to mitigate any potential long-term effects of a concussion.

Many people who sustain a head injury see their symptoms go away. However, some people—especially women—might experience long-term consequences. Bretzin advises those who fit this description to speak up about their suffering. She advises discussing with your doctor or other healthcare professionals your knowledge that women are more likely to experience ongoing symptoms following a concussion. “Ask about rehabilitation centres and organizations for other concussion victims. It’s crucial to understand that your symptoms might need ongoing attention and management, and there are experts who can support you in this process.

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