My friend's son (10 y/o) is certified as a junior o/w diver. He has about 6 post cert dives under his belt. He also plays tackle football and suffered a "mild" concussion approx 6 weeks ago.
He was taken to a neuro who advised him to stay off the football field for the rest of the season (approx 3-5 weeks from the date of injury).
He had mild memory/recall issues, difficulty in performing math (which he previously knew) and other complex tasks, and some difficulty in regulating his mood. These symptoms have (I believe) now completed subsided.
When should he be ok to dive again? Does anyone have experience to offer?
I searched old posts but couldn't really find a definitive answer for adults, much less kids.
The neuro has no experience with diving and cannot speculate about its effects on a child with a mild concussion.
I am a DAN member but my friend and his son are not. If I call in, will they still be willing to offer a referral?
I had an issue with a concussion from a bicycle crash a little over a year ago.....which we discussed on this forum (
http://www.scubaboard.com/forums/di...ad-disturbing-incident-yesterday.html)......I had thought I was entirely over the effects of the concussion....I never blacked out, but the concussion was significant....after 2 months , I thought it was far behind me...but it was not....
The short version of this.....chemical changes in the brain from the concussion, don't resolve neccessarialy in even 2 months....it may be more like 4 to 6 months....and that would really take a neurologist to consider answering....
So while I thought I was fine, I did a dive on a 110 foot wreck, shooting video of Goliath Groupers all over it, with lots of me swimming at Goliath speeds to get the shots
This caused CO2 buildup, particularly at depth.....While I was fine on the dive, and shot some of my best video ever......during the surface interval I was apparently repeating myself constantly to my friends and to my wife, and they were all wondering what was up....the second dive was shallow, I don't know it it did anything beyond what the first dive did.....no one does really....but when the boat got back to the dock, I did not know where I parked my truck, and did not remember talking to people that I had been in animated conversations with, just prior to the boat going out that morning...this was all just GONE....Memories no longer mapped , just gone.
DAN covered the tests, they were great in the amazing assistance they offered....Ultimately the neuroligist was of the opinion, that I had had Transient Global Amnesia....caused by the high CO2 levels from high workload on the 100 foot dive, running CO2 levels up high enough that the already altered brain chemistry, was effected so much that the Amnesia resulted.
This never happened to me again....I began diving again about 2 months later, and waited a few more months before doing any deep dives, or doing any high workload dives that could run up CO2 levels.
Over a year later, I could do a 300 foot dive, and work....no problem....But the Concussion issue is serious for diving. I think Your son should pass on this for another couple months....at the very least, if he dives, he must NOT work hard/should not swim fast, not do anything to build up CO2. That would include snorkeling and breath holding.
Here is some of the stuff I was reading in the weeks after the amnesiac event..when I was trying to figure out what had happened.
- A concussion involves changes in the chemistry of the brain, although you do not need to lose consciousness to have a concussion. The chemical changes in the brain last longer than the symptoms, so your doctor will typically recommend that you rest and avoid contact sports for at least a week. Pasted from <What is a Concussion? - Concussion - University of Rochester Medical Center>
- ... there are chemical changes that occur with a jolt or blow to the head. Immediate signs and symptoms of chemical changes may include:
· Amnesia – especially to details before and/or after the event Pasted from <About Concussions>
- Simply stated, a concussion causes chemical imbalances in the brain to occur. The brain has to then regulate itself to bring the chemical imbalance back to normal.These imbalances cause the brain to work overtime to return itself back to normal. To do this the brain needs blood. However, when the brain is concussed there is a decrease in blood flow to the brain. This inability for the brain to get energy from the blood creates an energy crisis. With all the systems in the brain working over time and a decrease in blood flow the neurons in the brain malfunction which cause the signs and symptoms that people feel when they have a concussion. These concussion symptoms can last briefly or last for a long period of time, while the brain tries to recover.
- Similarities exist between Alzheimer’s patient brains and post concussion brains….the similarity I would investigate, relates to the new theory of Alzheimer's actually being brain wastage from insulin resistance in the brain and inability to use sugar for brain fuel….{ Extra virgin Coconut oil CURES this...I have largely CURED my mother's Alzheimer's with this, and 3 other family friends...So maybe in my supposed Post Concussive State, I should be consuming Extra virgin Coconut oil several times per day for brain fuel/nutrition}. We know that in a post concussed state, there is a lowered ability for the brain to get energy….
……….With this in mind, my issue may not have been with O2 Toxicity, but rather with an "eggs only" breakfast 4 hours prior to diving, as well as my having had some issues with insulin insensitivity in the recent past...and then after some high aerobic demand activities before and during diving, a combination of low blood sugar in the brain, and Post Concussion effect reduced energy available to the brain--led to a memory loss more like a diabetic episode...
The brain has a high metabolic rate and requirement for constant sugar. This fuels neurotransmission, which affects learning and memory.
A lapse in the system causes a reduction in the ability to remember things.
In cases of uncontrolled diabetes, prolonged high or low blood glucose levels make the hippocampus malfunction, which may influence concentration, attention, memory and information processing.
Pasted from <Diabetes and Memory Loss>
- Cortisol, an essential hormone in the body that is strongly linked with diabetes, may also affect memory function. Higher and prolonged levels of cortisol in the bloodstream may affect the brain and cause memory loss. My thinking on this is that Post Concussion effects could easily include high cortisol levels…Pasted from <Diabetes and Memory Loss>
High levels of Cortisol, in a post brain injury individual, could further interfere with the memory storage of a diver running on insufficient blood sugar for normal brain function….Whether or not High PO2 would further disrupt this energetic balance, or the electrical potentials...is yet one more issue to consider….we know that high PO2 is going to cause more Oxidation… Pasted from <Concussion and Alzheimer?s Patients Show Similar Brain Changes | TIME.com>
- Additional Blood chemistry issues at pressure….potential for CO2 buildup to cause acidosis and or histotoxic hypoxia. Potential decreased functioning of Carbonic Anhydrases which would result in poor buffering and higher levels of acidity in the blood/brain area.
Metabolic acidosis is caused by an increase in the level of acids due to increased acid production or ingestion of acids….High exertion at 110 feet on a dive, would create high levels of CO2 buildup, high blood acidity...and a chain reaction, including lower thresholds for high PO2 tolerance. I did have sore leg and gluteal muscles for 2 days after the dive….if you watch the video, I move around more like a jewfish in speed and distances covered, than like a diver. Pasted from <Metabolic Acidosis: Symptoms, Causes and Treatment>
Accumulation of lactic acid is another contributory factor. It usually takes place due to insufficient availability of oxygen in carbohydrate metabolism...We know high CO2 levels would have existed in me on this dive, relative to most divers....see the video and how I am moving at the speed and distance ranging of the jewfish....Paradise in Boynton Beach - YouTube
Metabolic abnormalities can lead to acidosis. Use of fat instead of carbohydrates, for deriving energy, as in the case of diabetes mellitus, can lead to an excessive production of acids. Breakdown of fats produces ketones and raises the level of acids in the body. This condition is termed as diabetic ketoacidosis.
- And finally...When there is a sufficient blow to the brain, the membranes of the affected nerve cells in the brain are stretched or twisted, allowing potassium to exit those cells, which triggers those cells to depolarize, thus the phenomenon of seeing stars if the affected area is involved with sight or ringing in the ears if the affected area is involved with hearing. The exit of potassium (K+)peaks approximately two minutes after the incident but continues for another 3-4 minutes.Then, until the chemical balance is somewhat restored, those neurons (nerve cells) are unable to fire again. Furthermore, in a protective reflex of sorts, surrounding cells begin to shut down, a process Hovda calls“spreading depression.”
If enough cells become depressed, confusion, amnesia, and even loss of consciousness result.
Meanwhile, in an attempt to recover, the brain starts using up massive amounts of blood sugar and will continue to do so for as long as 30 minutes.This overuse of this glucose results in the production of lactic acid which, in excess amounts, inhibits brain function.
