Dr. Mark D'Esposito

What I found in neurology, a lot of what patients want to know is they just want to understand their problem.

They're not walking in expecting a cure.

Just understanding what it is, having someone understand what happened to them is very helpful and comforting.

What we mean by concussion, and in the clinical world we use mild traumatic brain injury kind of synonymously with concussion, it basically is a tearing of axons.

The brain cells have these long fibers that communicate with each other, and they're called axons.

And when the brain violently moves forward and backwards, if you're in a car accident and you have your seatbelt on and you suddenly hit, you go from 50 to 0,

your head violently goes forward and violently goes backwards.

And that angular force actually tears and stretches axons in the brain.

So if you've had a concussion, you have torn some axons.

I mean, luckily we have billions of them.

And so if you tear a couple of thousand, you will recover, but you have torn axons.

It's a real neurological, it's a real brain problem.

injury, even if you haven't lost consciousness and you've only had symptoms for a couple of days.

And there's a correlation, the longer you've lost consciousness and the longer your symptoms last, the more axons you've torn.

There's kind of a direct relationship between the two.

So the mechanism is these torn axons, so now nerve cells don't communicate with each other and different brain regions are not communicating with each other.

And it turns out the most common place for axons to tear is in the frontal lobes.

And so now we talked about all these things that the frontal lobes do to orchestrate the rest of the brain.

Well, it has some injured pathways.

And that's why a lot of the symptoms that patients have are these kind of mild executive symptoms.