You don’t need to hit your head to suffer a traumatic brain injury.
Did you know that you don’t have to hit your head to sustain a traumatic brain injury (TBI)? It’s true!
A TBI can happen when an external force is applied to the body that is strong enough to make the brain move inside the skull. Imagine your brain as a rubber ball inside a box. This is obviously an oversimplification of course as the brain is far more complex than a rubber ball. If you move the box with enough force, the ball will move around inside the box. The brain, like the ball, can move inside the skull because it is suspended in fluid. The brain can move forwards, backwards, side to side, rotate and twist, and this movement can cause injury to the brain tissue. A classic example of this is known as a coup contrecoup injury and occurs when the brain moves and strikes the inside of the skull and rebounds off the inside of the skull and hits the opposite side of the skull.
The brain’s consistency has been compared to soft butter, gelatin, jelly, or tofu. The composition of the brain is not uniform but has different areas known as gray and white matter. The gray matter is the outer part made mostly of neuron somas and white matter lies under the gray matter and is made of mostly axons. Rotational forces can cause the brain to torque and twist inside the skull and the shear strain forces on the brain can stretch and tear the brain’s elongated nerve fibers.
The inside of the skull isn’t smooth. It has hard ridges. If the brain moves or rotates across these hard ridges, tear of brain tissue can occur. Bicycle helmets are now designed with safety features to help decrease these rotational forces. MIPS is one kind of technology designed to help reduce rotational forces. It is a yellow insert inside the helmet designed to slide on impact to help decrease any abrupt rotational forces on the brain. Another newer technology is called The Release Layer System, and is designed to roll and release shell panels on the outside of the helmet to reduce the forces on the brain.
A shaken baby or whiplash from a car crash where the head snaps forward and backward are examples of external forces on the body that can generate enough force to move the brain inside the skull and cause trauma without a direct impact to the head.
Even if you didn’t hit your head or get hit in the head by an object, but enough force is applied to the body and head, the brain can move inside the skull in a way that can cause a brain injury. This is why it is important to seek medical attention after an traumatic event or incident like a car crash, a bicycle crash, or fall even if you didn’t strike your head or don’t know if you hit your head.
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If you found this post helpful, you might also like to explore the other topics listed below and the many other topics in our comprehensive Safety & Prevention Guide, Brain Injury Guide, and Bike Injury Guide.
