Head trauma

Whether you’re a Sunday cyclist or a high-level athlete, injuries spare no one. They make us sad and grumpy and deserve an explanatory sheet using the 5Ws and 1H method for each. The idea behind this series of short articles is to better understand them, adopt the right behaviors to avoid them, and know what to do for a better recovery.

I propose to review each time, using the “5Ws and 1H” method (What, Who, Where, When, How, Why) and in as many articles as there are recurring injuries in cycling and triathlon, all possibilities of frustration related to forced rest.

After the knee, the clavicle, saddle sores, spinal pain, iliac artery endofibrosis, Achilles tendonitis, compartment syndrome and carpal tunnel syndrome, today I offer you an explanatory sheet – still using the 5Ws and 1H approach – this time for head injuries.

By Jean-François Tatard – Photos: Frédéric Poirier, wikipedia, Pxhere.com, Pixabay.com, Flickr.com

WHAT?

A head injury refers to the sudden deceleration of the brain. All of a sudden, the brain is subjected to very violent deceleration and acceleration forces, which will create a quantity of disseminated micro-lesions. To make a mechanical comparison: all the cables will be damaged. Often, there can be a loss of consciousness and sometimes even more serious sequelae.

WHO?

Do you remember that terrible accident, that summer of 1995 that plunged the Tour de France into mourning? The crash of Fabio Casartelli, then Lance Armstrong’s teammate in the Motorola team, made riders aware of the risk they faced when crashing without a helmet. Each year in France, approximately 150 people die after a bicycle fall. And do you want another statistic? In 90% of cases, the cyclist who dies from the consequences of their fall was not wearing a helmet. Most of the time, these deaths are caused by irreversible brain damage, a direct consequence of a head injury.

You who read 3bikes, also think of your children! Indeed, it is particularly important to protect children, because their developing brains are much more fragile than ours. They are three times more likely to develop permanent sequelae following a head injury. Still too few children wear helmets regularly. However, the government has made bicycle helmets mandatory for children under 12. But it is important to continue even after that age.

WHERE?

While everyone remembers the death of Andrei Kivilev at Paris-Nice 2003, it was also from that date that wearing a helmet in competition was made permanently mandatory by the UCI. Nevertheless, riders long maintained the habit of continuing to train without a helmet. Big mistake! In 2017, Michele Scarponi died as a result of a training crash. A skull fracture with cerebral hemorrhage and edema. This is the risk incurred when you fall on your head. It is often cerebral hypoxia, meaning the death of brain cells due to compression and lack of oxygen. Intervention must be as quick as possible. But this is not the only source of injury.

Indeed, a head injury leads to significant physical as well as neuropsychological sequelae. When the worst has been avoided, head injury victims often suffer from memory problems, mood disorders, or even personality changes. All these symptoms obviously have a considerable impact on the victim’s family and professional life.

WHEN?

Each time the head swings back and forth, it undergoes acceleration, then violent deceleration. These brutal movements cause lesions in the brain’s wiring system, which are called the axons of neurons. Nerve cables are stretched or sheared by the impact, which can lead to more or less severe lesions. The wiring system is completely disorganized in places, and the functioning of neurons is then interrupted. This can result in a brief loss of consciousness or a prolonged coma.

HOW?

Is the helmet the best solution to protect yourself from head injury when you are a cyclist? The answer is obviously yes! Helmet wearers would have a 60% lower risk, compared to bare-headed cyclists, of being seriously injured in the head in the event of an accident. A helmet that fits properly – and it’s important to emphasize this – THAT FITS PROPERLY – effectively protects the brain and skull. Wearing a helmet will reduce the violence of the impact.

A helmet that fits properly – and it’s important to emphasize this – THAT FITS PROPERLY – effectively protects the brain and skull.

In the context of a head injury, rehabilitation is crucial for recovery. It often involves a very comprehensive approach. Rehabilitation is necessary for patients to regain motor functions. However, cognitive impairments can persist, as can problems with concentration, decreased attention, or even behavioral disorders. Tests of sensitivity, reflexes, memory, and concentration… provide a complete picture of what happens after a mild head injury.

Headaches, fatigue, anxiety, mood changes… even mild head injuries can lead to sequelae that only appear long after the accident. A study is currently underway to highlight the need for managing even the mildest cases. Don’t let it drag on if you are ever affected!

WHY?

All the disorders I mentioned above appear because the trauma caused invisible lesions within the nervous tissue, even on a scan. These occur at the axon level. They are called diffuse axonal injuries. These conduits are stretched and sometimes even ruptured following trauma. These disorders are very long to rehabilitate.

So why is the helmet your best savior in the event of a head fall? For a simple reason: it will be the helmet, and not the skull or the brain, that will absorb the kinetic energy released by the impact. Wearing a helmet will considerably limit the violence of deceleration in the brain, and therefore the sequelae. We can never tell you enough: “Wear your helmets, guys!”

CONCLUSION

In the next explanatory sheets, I propose to continue reviewing the injuries that most often paralyze us. Next time, we will look at digestive pathologies, plantar fasciitis, and shin splints.

=> SEE ALSO: All our Infirmary articles
=> SEE ALSO: All our Coaching articles