2017-04-07 Rider Down, Uxbridge Road Acton - Concussion Awareness

The rider was me at 22mph I came off the bicycle and from the rear facing camera, seem to have come to a close to instant stop. My head hit the curb and I was unconscious at the scene for roughly 90 seconds during which time 2 cyclists had stopped, and called an ambulance as blood was coming out of my head.

Whilst waiting for the ambulance two doctors on their drive to work also stopped and by this time I was conscious. They offered to take me to A&E as it would quicker than waiting for the ambulance.

I was lucky.

Despite my head taking all the impact, I had no broken bones and neck and spine vertebrae were all aligned. I did suffer a minor brain injury (TBI) though and that is why I created this thread, for awareness. I think everyone should be familiar with symptoms and after care / support options in case you find yourself or a friend in that situation.

The helmet stopped my head cracking but does not really stop my brain slamming up against my skull on the inside which is concussion.

I suffered a small bleed and frontal lobe swelling and was kept in hospital for 4 days under neural observations before being discharged.

On discharge I suffered with dysfunctional short term memory and also couldn't filter distractions out and focus, so a family meal at a restaurant became quite overwhelming for me being aware of all the sounds, foot traffic etc. This was very scary because I hadn't been warned of after effects and didn't know if it was permanent.

On the scale of things, my brain injury is very minor and as such, it's easy to kind of fall through the cracks in terms of care / advice. I found getting after care very challenging but am lucky enough to have a good support network who pointed me in the right direction.

The after effects I am suffering are common and known as Post Concussion Syndrome (PCS). Despite how common it is, there is some ignorance even in medical / GP circles. There is a UK charity called headway that has a wealth of information on their website:

https://www.headway.org.uk

This is my first post on this website despite some years of browsing (after buying a new 2005 fuji track) and it may look a bit spammy but I really urge everyone to just skim some of the information that headway have.

I seemed quite together at the scene of the accident and my concern is that maybe someone might have believed I was fine if they weren't as careful or aware of concussion. The biggest danger with concussion is taking another blow to the head, in my case as I had a bleed another blood could worsen the outcome.

It is now a moth after my accident and thankfully I am starting to feel more normal. My ability to filter out background activity is almost 100% although I still have to concentrate a bit in busy environments. I have being making a phased return to work and short term memory has also improved although still not 100%

I'm not allowed to cycle (or drive) for 6 months mainly as a precaution which is why I browsing the forum once again.

I think headway is a great source of information and perhaps something on concussion dangers and aftercare could be added to one of the sticky threads?

I'm not an expert but will try to answer any questions that any of you have on my limited experience.

Below are some search words that might help someone searching in the future. At present the linked site explains all of these:
event amnesia / post traumatic amnesia
Brain haemorrhage, bleed
agression / (sexual) disinhibition
subdural hematoma, contusion, subgaleal hematoma
concussion / concussed/ unconscious

This is very informative and thanks for sharing!

Get to 100% soon.

Interesting. Glad that you wore a helmet it could have been much worse

Thanks guys. Yeah, I hate to think what would have happened without the helmet.

The impact was around my left temple area towards the forehead where, oddly the helmet is not that thick. There is a small dent in it now and even a little compression can help lots. The top of my head has not been tender (not painful) since, only really being OK last week.

My sunglasses were smashed up but the lens chipped but didn't crack or break.

I didn't suffer behavioural changes which is very common with concussion. Concussed people can become aggressive, even to those trying to help. The same area of the brain that controls that aggression also controls inhibition and sexual desire so it is also common for concussed people to to become sexually inappropriate. With the camera footage, I was reasonably sure my personality remained OK but I still had to ask the people I communicated with a week later because aside from a few seconds here and there, I can't remember the day of the accident, before or after.

Do you think if you'd not been wearing a helmet you might have cycled more cautiously and avoided the accident?

I ride without a helmet and have never hit my head on the kerb, so based on your and my experience wearing a helmet seems very dangerous.

I've been through this. It is horrible. If you need some support-feel free to PM.

Um. What?

I'm being a dick because I'm bored. That's what you're supposed to do on the internet.

Don't headway have a bit of a 'reputation' in relation to cycling and helmets ?

I did about ten years of club cycling and never wore a helmet. It still feels alien to me but traffics a heck of a lot worse and more aggressive and my then girlfriend cried about me going out without one, I still have a sneaky cycle early in the morning without one which many would say is irresponsible but I never get used to the feel. Hope you get better soon and thanks for the share.

Please let's not turn this in to a helmet debate.

Boooo. Spoilsport.

Srsly tho.

I'm pleased the OP is on the mend and headway do great work.

this.

I got badly concussed as a result of being hit from behind by a speeding motorist, the helmet was split in half and I had a concussion for about 6 weeks with eyes that looked like a slow loris's but the wonderfully inattentive shits at Harlow General where I'd been carted to on a spinal board didn't bother to tell me that, it was the horrified GP I saw two weeks later who was amazed to find me able to wander in to the surgery complaining of feeling sick and lightheaded under my own steam.

The helmet question wasn't and will never be part of the equation for me-it was shitty driving, poor medical care and then subsequently a total lack of action on behalf of the police that characterised the cause and effect of the whole situation and the quality of my recovery and I could just have easily broken my spine or been run over by the following car that skidded to a halt about a foot from my head.

OP- it took me almost a year to return to normal, things like balance, emotional state and vision were really badly impacted so I'd say a six month hiatus on driving is pretty reasonable although I did cycle from about 2 months after just because I couldn't afford to get around any other way.

Thanks :-)

übé®_grübé®
übé®_grübé® How long ago was that and have you recovered fully now?

I've been quite amazed at the lack of awareness on post concussion effects from my experience. I would hope it is getting better but your experience implies it is widespread as feared.

I think the danger is that if you are up and walking around, especially a few days after the accident, people think you are OK.

I tried to cover up my symptoms at first (badly) because I was part ashamed and also didn't want to be a bother. Once I started telling people, some people were able to offer advice. I am also on another (running) forum and a few people there told me their experience and it was such a relief for me to hear they recovered.

That was in 2012, so a fair while ago now. I'd say my brain's recovered even if I still get a bit anxious about cycling in a way I never did prior to the accident although I think that's just natural self-preservation instincts. I just consciously plan my rides to avoid particularly fast roads or massive roundabouts (where I got run over...)

Yeah it's a weird thing for concussion not to be flagged as a matter of routine-it certainly was when I did first aid a few years later so fuck knows why actual Drs don't bother to check. When I got taken into hospital I was given x-rays as they thought I'd broken my back but nobody checked for head trauma and I was sent home within 12 hours even though I'd a fractured pelvis so generally a pretty shit experience. The GP I saw a few weeks later said I should have been kept in for at least a few days to make sure I didn't have bleeding in the brain and that even two weeks later it was bad enough that she was worried about sending me away without further tests so it seems as much luck as anything else that nothing bad happened. I definitely remember really extreme emotional swings from anger to sadness but just put that down to shock or being pissed off about the cunt that hit me trying to blame me for the collision even while I was lying on the road unable to move... pretty fucking infuriating even now!

I hope you're taking it easy and giving yourself time to recover anyway-not always possible because of work and the need to pay rent etc but important to do as much or as little as you feel like and to avoid alcohol and caffeine or other stimulants and get as much sleep as possible to give yourself the best chance of recover. I'd also recommend taking really high quality fish oil if you can-lots of Omega 3s will also be really helpful, as will zinc, magnesium and vitamin B3.

That's all very interesting guys. lots of good info so far...thinkg I'll keep in mind if anything ever happens. Fingers crossed.

Sorry to hear you went through this. Good of you to share your experience on here to make others aware of what to expect/potential outcome of such an incident.

übé®_grübé

I think I got off lightly when reading your account übé®_grübé.

Luckily work has been really good and not pressurising me to do anything strenuous.

I just read the neurologists referal request to my GP and my 6 month driving ban might be extended to 12 months if this weeks scans pick up any further bruising on my brain so perhaps a year to recover is expected?

I can cope with not driving as I don't drive a car any more due to house move. If cycling is still off the cards I will ask about spin class or something or maybe look at getting a cheap geared bike and indoor trainer. Or if I can run, I will just do that.

Good recommendations on omega3. I have been snacking on mixed nuts and taking a fish oil supplement and generally trying to eat better than I was post accident. My sleep requirements are reducing but I'm still needing 10 -12 hours where before I was a 7 person.

A couple of things I have found help sound quite simple:

1. Going to a supermarket to buy a couple of items. (there is a lot going on in a supermarket, bright lights, chaotic people traffic, remembering and navigating for your shopping etc)

2. Using a map to navigate outdoors without a guided GPS route. Actually having to look at street names has been a help and a skill I had lost. Ideally I like to walk through parks where possible.

3. Brain training apps. I just paid for 3 moths of neuronation but you can try it for free. Initially I discounted these believing using the app only makes you good at using the app. To be honest, I still think that is true but the neurologist told be they have some value so I do about 15 / 20 minutes a day on the train. I figure it can't hurt.

4. Social media reduction. Hard to believe as I am new poster here but I have cut down (not out) my browsing time on social media, Facebook, having multiple tabs open etc. That kind of goes hand in hand with #1 & #2

5. Trying to eat better. This is mainly for 2 reasons, the first being vegetables are doubt better for my brain heath than New York cheesecake. The second is that I have gone from cycling 26 miles most days on a 69GI (42x16 cog) fixed gear bicycle to just some walking and having just struggled to loose 10kg, I really don't want to put it back on.

6. Hanging around with friends who have children. I'm not in a fit state to be the primary adult but just being around children stimulates more of my brain than any adult could - fear when they run close to the road, to concealed anger when they treat my flat like a bouncy castle, to explaining things to them, laugher and genuine fun. Certainly under 5s really do exhaust me so brain must being going into overdrive firing neurons.

7. Generally, the above things have shown me that the most useful things (for me at least) are variety and doing the things I should probably have always been doing.

** Update **

7 weeks later and I feel normal again and can function at work.
I still have some residual brain bruising that shows up on an MRI but doesn't seem to impact by daily life. Dr advised keeping the driving / cycling ban for 6 months but I am allowed to run which will keep me happy and the belly at bay.

While I had this problem I was asking for help anywhere I could get it. I found about 1 in 30 have been through similar, be that in forums, social / active clubs, work etc so I if it happens to you or someone you know, I recommend talking to people. I don't think anyone really gets it unless they have been through it but lots of people have.

My injury was mild, as I was unconscious for less than 30 minutes and amnesia of the event did not exceed 24 hours. Below is a table I found with a common list of symptoms following a head injury (you can google what they mean).

The list is taken from the following paper:
https://www.researchgate.net/publication/7698193_Sensory_gating_impairment_in_development_of_post-concussive_symptoms_in_mild_head_injury

In addition to the list below, headaches can be expected. I had daily headaches for about 4 weeks before they became less frequent and finally they seem to be gone.

Not being able to filter (sensory gating) out background sounds, activity. For me this was the worst. The overstimulation / processing would raise my anxiety levels and put my in a fight / flight state. Thankfully that has also passed.

My recovery didn't seem to be progressive. Rather, there would be no change for a few days, then a big improvement.

Being able to describe the symptoms you are having can be of use in getting help.


**Neurobehavioral problems 		% patients reporting those problems** 

Inattention/reduced alertness 	33.3 
Somatic concern 				73.3 
Disorientation 				6.7 
Anxiety 						50.0 
Expressive deficit 1			6.7 
Emotional withdrawal 			13.3 
Conceptual disorganization 		0.0 
Disinhibition 					16.7 
Guilt feeling 					30.0 
Memory deficit 				46.7 
Agitation 					16.7 
Inaccurate insight & self-appraisal 16.7 
Depressive mood 				63.3 
Hostility/uncooperativeness 	16.7 
Decreased initiative/motivation 	43.3 
Suspiciousness 				20.0 
Fatigability 					43.3 
Hallucinatory behavior 			6.7 
Motor retardation 				16.7 
Unusual thought content 		3.3 
Blunted affect 				3.3 
Excitement 					3.3 
Poor planning 				3.3 
Labile mood 					3.3 
Tension 						53.3 
Comprehension deficit 			16.7 
Speech articulation defect 		3.3