… so many questions
All blows to the head should be considered serious & evaluated by a physician
It’s a very long list but falls are #1 followed by striking or being struck by objects #2 and motor vehicle accidents #3. Head impacts can directly damage the skull and/or cause bruising (with or without bleeding), tearing, and swelling to the brain inside. If that’s not enough, centrecoup injuries, a back and forth movement as in whiplash, can damage brain tissue on the opposite side of impact.
Most TBIs each year are mTBIs or concussions often caused by a bump, blow, or jolt to the head or by a body hit causing the head and brain to move quickly back and forth (whiplash). This movement can cause:
Brain to bounce around or twist in the skull
Chemical changes in the brain
Stretching, shearing and damaging brain cells
They are usually not life-threatening. Even so, effects can be serious and long lasting.
People with mTBI or concussion need to be assessed by a healthcare provider.
Healthcare providers can do tests to check for a mTBI or concussion.
Consider using telemedicine services if you are unable to visit a healthcare provider in person.
These brain changes can lead to symptoms that may affect how a person thinks, learns, feels, acts, and sleeps.
Often in sports, players suffering a blow to the head say “Put me back in,” or a coach says “Just walk it off.”
Bad ideas. Blows to the head lead to faulty decision making. Many sports even have concussion protocols; get it evaluated. Let your brain rest, there will be other games.
Repeat injuries can occur and lead to worse things. Refer to What is CTE –>
Symptoms may present as physical, cognitive, emotional or behavioral effects, appearing individually or in combinations.
In rare cases, a dangerous blood clot can develop crowding the brain against the skull. Call 911 or go to an emergency department if:
Danger signs in adults
Have a headache that gets worse and does not go away
Experience weakness, numbness, decreased coordination, convulsions, or seizures
Vomit repeatedly
Have slurred speech or unusual behavior
Have one pupil (the black part in the middle of the eye) larger than the other
Cannot recognize people or places, get confused, restless, or agitated
Lose consciousness, look very drowsy or cannot be woken up
Danger signs in children
Call 911 or take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and: will not nurse or eat; have any of the adult danger signs listed above; will not stop crying and are inconsolable.
First things first, let’s get rid of the ‘D.’ Post traumatic stress is NOT a disorder, it’s a normal bodily response to stress brought on by loss of:
- Control
- Safety
- Predictability
PTS can initiate from either or both internal & external environments.
Think of this analogy: neurons are like the building blocks of the brain. Concussion/TBI is like an earthquake which can affect parts of the brain far from its epicenter (the point of concussive impact), often times memory, decision, and focus.
TBI is a diffuse injury; it’s common, complex, and difficult to treat. No two are the same.
After concussion or “mild” TBI (mTBI): although 80% achieve complete recovery within six months; “mild” has no bearing on any one individual’s subsequent affects. Mild concussions can cause life-long challenges.
Co-morbidity of TBI and PTS: is common (25-45% co-diagnoses) with 636,000 possible combinations of symptoms.
TBI and PTS together complicate treatment, often bringing a sense of disempowerment, irritability, slower cognition, and sleep difficulties.
Resilience is the ability to more effectively move through adversity. (Ten qualities displayed by resilient people, Resilience: The Science of Mastering Life’s Greatest Challenges)
Plasticity & neurogenesis enable brain healing to occur if conditions are right. The brain’s goal is to achieve (or regain) predictability and control.
Love Your Brain – Veterans Yoga Project Zoom presentation 9/21/2022 by Erik Won, MD, Wave Neuroscience, USN
TBI is overwhelming at first, particularly when symptoms like sleep disturbances, mental and physical challenges lead to confusion, frustration, and indecision along with the seemingly endless roller coaster of medical visits, prescriptions and uncertaintly.
There are two excellent ‘beginner’ references we suggest:
First is Head of Hope, a personal story of survival, resilience, distress and hope by Jennifer Soames, a long-time Klatch member. It describes her path as a TBI survivor which is so similar to what many of us encountered.
Second, Dr. Glen Johnson, a clinical neuropsychologist in Michigan, wrote an excellent, down to earth TBI Survival Guide. It’s well organized and a good starting point for learning about brains, brain injuries and what comes after.
Finally, but maybe this should be #1, find a TBI support group. You will be welcomed and amazed by how eager your peers are to listen, understand, empathize and share your journey. It’s not uncommon for the strongest, toughest, “I don’t need a support group” survivors to have tears when initially embraced by their new TBI family.
Brain injuries are classified and described in different ways. Each injury is as unique as the brain it affects but western medicine (i.e. insurance companies) likes neat and tidy categories. Here’s a good overview.
Yes, but …. recovery depends upon so many factors accurate predictions are nearly impossible. However, for most TBI survivors, it does get better. Brains do heal but it takes time; improvements can be subtle and continue gradually. Aging can complicate, imitate and/or mask brain injury symptoms.
A person with history of multiple or repeated TBIs or concussions may experience a longer recovery or more severe symptoms. They may also have long-term problems, including: ongoing problems with concentration, memory, headache, and/or physical problems, such as sleeping or keeping one’s balance.
Chronic traumatic encephalopathy, also known as CTE, is a brain disease likely caused by repeated head injuries. It causes the death of nerve cells in the brain, known as degeneration. CTE gets worse over time and has been widely publicized among certain professional contact sports. The only way to definitively diagnosis CTE is during an autopsy of the brain after death.
Thousands of others have been where you are now. Anger, frustration, grief, denial, the list goes on. It’s early days on what may become a lifetime journey to your “new normal” but you don’t have to reinvent the wheel or go it alone. Peer support groups are one way to get help, learn from others and avoid (or at least be aware of) hazards along the way.
Concussion and brain injury often have significant effects on one’s “normal” lifestyle and physical health. A whole-body approach is valuable. Take good care of mind and body to achieve your best life.
Usually mind & body play nicely together, sometimes they don’t. Brain injuries can change any number of factors affecting your overall health so it might not be “all in your head.”
