I think the inflammation + changed cellsignalling, due to dead cells in the close proximity to functional (parhaps not 100% functional) ones can lead to celldeath (apoptos) in the latter. This might be an explanation for the delayed onset of symtoms, yes.
The "cleanup" takes some time and might even clean some functional cells away. Possibly. At the same time I think the outcome would be even worse without a full scale cleanup by the glial cells in the brain. My first thought that came to mind, of immunosupression after an injury might not be a good idea..but who knows...

You could speculate that more rest after the incident could have made symtoms and deficits less severe. But if there is celldeath after the incident normally, maybe it is something you have to see as a part of the injury.

What MIGHT be the case in the first noticable symtoms of the delayed character is this (my personal and collected experience) :

Normally you have a buffert in the brains capacity. Lets say you have 110% capacity.

You have a first concussion and notice NO noticable deficits after the acute phase. What might have happened behind the scenes is that you have lost some cells or/and function in the cells. Your buffert is now used up and you are at lets say 100% capacity.

The next injury you have (or delayed celldeath because of the immuno-response (?)) might set you to 90% capacity and since you´re now under 100% you start noticing deficits!

Since concussions and braininjury in general seem to be cumulative its not hard to understand that the second and later injuries on top of another seem to be more severe, even if they caused the equal amout of damage.


You could (like everyone here in some stage of their recovery) sit and think about what happened. In some cases you can draw some valuble information out of it, but mostly it just takes energy from what you should be doing. And that is looking forward. THink about what you can do for the injured person from now on and be smart. Avoid things that aggrevates the symtoms and think about how you can make the new situation as good as possible for you and the injured person.

Best wishes from Sweden!
Emil