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Concussion: The Crash and its Immediate Effects

2018-04-10 - Send Feedback
Related: concussion, health

Legal disclaimer: Since we are not doctors, never follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional. OTOH, the study of brain injuries is at best in its infancy, like studying outer space with primitive telescopes.

The deep pothole that crashed me
f1.8 @ 1/350 sec, ISO 20; 2018-03-17 11:53:20
iPhone 7 Plus + iPhone 7 Plus back dual camera 3.99mm f/1.8 @ 28mm equiv (4mm)

[low-res image for bot]

How did the crash occur? It was a perfect storm of factors:

  • Negligent road maintenance (and not the first time, a worse road-cut-pothill 4 years prior destroyed my front tire a 30 mph)). In this 2018 instance, I SAGed back with a fellow rider who also had hit his head, with a likely concussion, albeit on a different pothole.
  • A deep an long pothole with no visible lip and with light strafing it parallel to the road surfaces so as to cast no shadow or provide any “black hole” visual cue. Worse, the shadow of an oak tree extended right to the pothole, making it look like just part of the shadow. At 25 mph with flat lighting, such things are hardly visible.
  • Speed of 25+ mph on downhills always demands attention under any/all conditions, but being slightly distracted by hamstring pain I was not attending at 100% to road conditions, yet this is a thing I have trained for, for years and it is embedded as a habit. I am not sure that even with full attention it would have mattered; my eyes were fixed on the road in front of me, and yet I did not see it in the shade.
  • Bad luck: the rear wheel snagged the edge of the pothole, crushed the carbon rim, and thew me violently to the right. Had I had a 27C rear tire instead of a 23C, I might have had the tire protect the rim and avoid the whole incident. My 2018 Moots Vamoots RSL allows the space for that larger tire. I have several times blown-out front tires at high speed, but each time I have safely come to a stop. Not so this time with the rear wheel catching and throwing as its carbon rim was crushed.
  • Violently veered to the right and now heading towards a slanted-up embankment, I knew I needed to go down quickly, or risk bashing into a barbed wire fence and or post. Thus I had little choice but to allow the bike to keel over, whereupon it caught hard in the soil and threw me violently into the relative soft soil and crash, but at ~25 mph for a direct non-sliding impact—not fully orthogonal, but at a good solid impact angle that did not allow sliding to dissipate the energy.
  • I have no memory between the fraction of a second after the front tire blew out (the instant “grass or pavement decision), and waking up on my back with eyes closed, feeling the computer slowly reboot and do a whole-body self-check on pain and broken bones before I opened my eyes. I was in shock I guess, and speech/verbalization was almost nil at this point.

I do not know if I was unconscious for 15 seconds, or 1/2/3/4/5 minutes, but I think it was probably 2-3 minutes. Upon awakening with eyes closed, I did a mental scan of all body part. Noting seemed to be broken or hurting. But what was remarkable was great difficulty in being unable to utter simple "yes" or "no" as passing riders asked if I was OK. But none understood that the lack of response was due to the inability to speak without tremendous effort, so none of them stopped!

Fortunately, two cyclists stopped to see if they could help. I remember lying on my back and hearing them ask if I was all right, rather a difficult question to answer—with great effort I croaked out a hoarse and scratchy “I think so”. Which of course was correct in a physical sense (bones and such), but I did not realize that the major damage was “brain slosh” in spite of no apparent damage to the helmet.

Following that, it took about 45 minutes to regain semi-normal speech, initially it being a struggle to make a short but complete sentence.

For serious cyclists: Thoughts on Recent Training, What I’ve Learned and What Remains to Learn.

The deep pothole that crashed me
f1.8 @ 1/350 sec, ISO 20; 2018-03-17 11:53:20
iPhone 7 Plus + iPhone 7 Plus back dual camera 3.99mm f/1.8 @ 28mm equiv (4mm)

[low-res image for bot]
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