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Pink Concussions


I attended a three day medical conference in Houston this week. The subject was Traumatic Brain Injury. The conference was attended by hundreds of professionals- I was the only ophthalmologist in attendance. Am I proud, or unhappy about this state of affairs? A little of both.

So I learned something new, something that should have been obvious to a reasonably smart guy like me. Women experience traumatic brain injury (TBI) differently than men. And women seem to get the worst of it.

Now, the landmark studies: NFL football players, and Veterans returning from the Middle East. Sure some of the veterans returning from war with TBI were women, but not many were actually enrolled in studies. And the studies concluded these women did much worse than females with TBI in the civilian world. That’s important data since increasing numbers of women are going to be serving at the front lines in combat roles.

Also, womens’ brains are different than mens’ brains. We don’t need experts to tell us this obvious result. Hormonal regulation and cycling are critical mediators in the neurochemistry of female brains. A man’s brain does not experience the large variations in hormonal exposure. Estrogen and progesterone can play a key role in female TBI.

Men tend to have stronger neck muscles than women. Thus, the rotational torque of a head impact can be more effectively absorbed by a man. And rotational forces are critical in damaging internal structures of the brain.

Women experience more domestic violence than men. Men can also be struck about the head in cases of domestic violence. Evidence shows women get hit about the head more, and with more force. Those woman get hit repeatedly, kind of like successive head injuries to football players. But there are no new safety protocols to sideline females from continuing to engage in contact. The aggressor determines the frequency. This is a sad and complex social problem.

Now, I write articles relevant to vision and TBI. And now I have some homework to do. Is the visual system of women different than men? For the most part their eyes are similar (not the same; for example, men have a much greater frequency of color blindness than women). But when you mix the brain and the eyes together (as they are in real life), the answers may be more complicated.

I learned the term “Pink concussion” this week. You never know, I might acquire the copyrights to “Pink Ophthalmology,” (too close to “pink eye,” but my audience gets the idea.)


Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as a Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.

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