INTO THE LIGHT

Doctors used to tell people who had suffered concussions to sit in a dark room until they felt better. Now they have entirely different advice—and much better results

- BY Vanessa Milne

After suffering a concussion in January 2023, Nicolle Weeks spent nearly a year fighting symptoms such as migraines, fatigue and dizziness. Initially, the 43-year-old didn't realize how severely she had hit her head.

"I was walking on the sidewalk, and I slipped on some black ice, fell backward and bounced my head off the ground," she says. She lay flat on her back with her arms out for a minute in shock.

Satisfied she wasn't injured, she dusted herself off and hurried to meet a friend for brunch. While there, she felt far away and dazed when her friend was talking, but it went away, and she didn't think much of it.

It wasn't until one week after her fall that Weeks was officially diagnosed with a concussion. That delay in treatment could be one of the reasons her symptoms persisted for so long.

Previously, doctors prescribed the 'dark room' treatment—total rest in the dark while avoiding all mental stimulation. But thanks to recent research, we now know that too much rest and isolation can be harmful for recovery and that the best approach is somewhere in the middle: active rest. This slow and progressive return to activity helps patients recover faster and lessens the risk of long-term damage.

Here's what doctors have learnt, and what you need to know.

WHAT HAPPENS DURING A CONCUSSION?

The brain is protected by shock-absorbing fluid and, outside that, the skull. In a concussion, the brain bounces around in the skull, accelerating, decelerating or rotating. This creates a cascade of impacts. The neurons in the brain are rattled, and between those neurons, the axons—thin fibres that transmit electrical impulses—stretch or break. The impact can also decrease blood supply to the brain and damage the neurons' mitochondria, which create energy.

Inside the brain, it's like an earthquake has happened. Everything is still standing, but there are cracks in the roads and in building foundations.