Dive Medicine
Concussion and Diving
BY DR. DAVID SAWATZKY
C 58
oncussion and Mild Traumatic Brain Injuries are extremely common and may have a significant impact on your ability to dive.
What constitutes a concussion or mild traumatic brain injury? Picture the brain as a sponge inside a boney shell.
If you apply force to one side of the shell (for instance, hit the head with a baseball bat), the shell will move quickly while the brain tends to stay put. This results in a compressive force on the brain on the side of the impact and a ‘stretch’ force on the opposite side. In addition, the brain has areas of different density. The more dense areas will move differently than the less dense areas. This will result in ‘shear’ forces scattered throughout the brain.
The force can be applied to the brain in two ways. The head can be still and you can suddenly move it (as in our baseball bat example) or the head can be moving
Magazine
Although enticing, you
should not return to diving until all of the signs and symptoms from the concussion have resolved
and you can suddenly stop it (fall and hit your head on the sidewalk). The net effect on the brain is the same. So, you can damage your brain by being hit on the head or by hitting your head. You can also damage your brain by force being applied in other ways. For example, if someone holds your head and shakes it violently (shaken baby syndrome) or you fall and land on your bum but don’t hit our head, you can still damage your brain. A further complication is that applying the same force does not always result in the same damage, either in the same person at different times or in different people. However, in general the greater the force applied to the brain the greater the damage. Usually, a small force will not result in any damage, so there appears to be a threshold effect.
Severity of Injury
Traumatic brain injury is roughly divided into mild, moderate and severe. Mild traumatic brain injury usually
Photo: Bill Coltart
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