Traumatic Brain Injury Dangers in the Winter

Winter sports are a fun and exhilarating way to enjoy the cold, snowy months. Gliding on ice, speeding down a hill, balancing on a board—it’s all quite exciting. But, high speeds and hard grounds can pose extra risks. Traumatic brain injuries (TBI) are a leading cause of disability and death up to age 44, especially among those who snowboard and ski. In the United States alone, health professionals see about 16,000 head injuries every year. Skiing and snowboarding have the highest incidence rate of head and neck injuries, with the latter making up for about 30% of concussions obtained during winter sports. 

Brain injuries are a serious situation that can leave a person with temporary or permanent damage. A TBI is when an outside force affects the functioning or activity of the brain, like a fall or sports injury, as opposed to an internal force like drugs or disease. There are three main types of brain injury. 

• Concussions are when the brain moves rapidly in the skull, such as by a sudden change in direction, momentum, or back and forth, and are the most common form of a TBI. The brain may twist or bounce which could cause chemical changes from the stretching and damage to the brain cells, vessels, and nerves. Unfortunately, there might not be any physical signs and it can happen without even hitting your head directly. 
• A coup-contrecoup is when the brain actually hits the inside of the skull hard enough to cause contusions at both the spot of impact and where the brain slammed into the skull. 
• Contusions are when the brain is bruised or bleeding. 

If an injury or incident has occurred and a TBI is suspected, these are a few tests to help diagnose and manage a patient: 

• The Glasgow Coma Scale is a practical scale to assess a person’s initial functionality after injury. It considers the eyes’ condition, verbal communication ability, and movement to understand the severity and guide the next best steps for the patient. 
• CT Scans are a quick go-to to check for TBIs in the emergency department as it can show bruising, swelling, bleeding, clots, and fractures relatively quickly.  
• MRIs are used for detailed imaging of the brain if symptoms don’t improve or the person is stabilized. 
• Intracranial Pressure Monitor is a probe inserted into the skull to measure any increases in pressure which could cause additional damage.

If a person has a mild traumatic brain injury, it may only require little more than rest and some pain killers. Rest includes a pause to both physical and mental endeavors, like using a computer or working. The person should be monitored to see if symptoms persist, get worse, or if new ones arise. Usually, a person is able to resume their routines after some time but doctor follow-ups may be recommended to ensure proper recovery. Immediate emergency care is necessary for anything else to stabilize the person and address any additional injuries and reduce any possible secondary damage. Medication or further medical attention like surgery will be considered case-by-case by the patient’s doctor. Depending on the severity of the person’s TBI, rehabilitation may be needed to re-establish any damaged skills which may include mental, speech, and physical therapies. 

While the event of a traumatic brain injury is a scary thought, simple prevention techniques can help keep you safe. Awareness of any environmental dangers such as ice, hard surfaces, or moving parts can help keep you on your toes (or rather, stable on your feet). While partaking in winter sports, wear helmets and other protective gear, ensuring they fit properly and are in quality condition. If you or anyone is showing symptoms of a traumatic brain injury after a hard hit or fall, seek immediate medical attention to minimize any permanent damage. 

Stay safe and have fun!