One May morning four years ago, Julie Supple was walking her golden retriever in her New Jersey neighborhood when he lunged at another dog. Supple, then 46, slipped on the grass and fell with a thud, banging her head on the ground. Right away she felt nauseated and had a pounding headache, but she brushed herself off and headed home. She had to get her daughter to school and herself to work.
Thankfully, that meant the hospital, where Supple, a nurse practitioner for a neurosurgery practice, had morning rounds. "I still felt sick and headachy but was trying to act normal. I didn't want to believe that anything was seriously wrong."
Her colleagues insisted she get a CT scan of her head, which would detect any bleeding. Though it came back normal, they admitted her to the hospital because she was vomiting, having crushing head pain, and too wobbly on her feet to walk straight. The diagnosis: severe concussion, a brain injury that's not detected through imaging tests but, rather, by assessing the degree of symptoms. It would take 4 months for Supple to recover and return to work. "I didn't realize at the time how sick I was," she says now.
Supple is one of the lucky ones, says her boss, John Knightly, MD, co-medical director of the Atlantic Neuroscience Institute Concussion Center at Overlook Hospital in Summit, NJ. She began to rest and recover right away, perhaps avoiding a worse outcome. "But many women ignore their concussion symptoms, thinking things will get better," he says. "That's a real health gamble."
Women at Risk
Some 1.2 million people get concussions every year, most of them mild. Another 500,000 suffer more dangerous problems, including severe concussions like Supple's, as well as brain bleeds such as contusions and hematomas, the latter of which killed actress Natasha Richardson in 2009. But even a minor concussion—when the brain shakes around in the skull—is far from harmless. If it doesn't heal, it could lead to memory loss or chronic sensitivity to bright lights and noise, says Dr. Knightly, or even increase your risk of dementia decades later.
Although recent media attention has focused on concussions in pro football players, research indicates that adult women may be especially at risk. "Women have smaller frames and neck muscles than men, which may make them more prone," says Daniel Labovitz, MD, assistant professor of neurology at the Albert Einstein College of Medicine in Bronx, NY. Once a woman is injured, the effects can be much more dire. In a 2010 study, women took longer than men to recover from concussions; this was especially true among women of child-bearing age. Fluctuating hormones may affect how the brain recovers from trauma, says Jeffrey Kutcher, MD, a sports neurologist at the University of Michigan. Other research found that female soccer players performed worse on neurological testing after concussions than men with comparable injuries.