Hi All,
I can also relate to this issue. I have experienced some cognitive problems but, frankly, given how bad the pain has been I have been surprised that my cognitive function is as good as it is. If the brain is generating such devastating pain, how come it works as well as it does?

I believe that the nociceptors giving rise to pain are located in the membranes surrounding the brain, rather than deep within the brain. So perhaps the functional bit of the brain is not the same as the bit that is giving rise to the pain. Could the membranes be inflamed, scarred or damaged in some way? That doesn't mean that the inner workings of the brain are not damaged at all. If the inner part of the brain is generating molecules that give rise to pain or electrical signals, these could perhaps give rise to pain in the membranes but not great functional problems. I don't know how much this idea has been investigated by scientists but it seems plausible to me.

Wtrpk, I would not say that you have NO functional difficulties. It would seem from what you write that the pain can be triggered by what your brain is doing. So, even if you are not noticing any loss of brain performance, the fact that you are feeling lousy the next day does surely mean that your brain is not functioning perfectly.

I have come across the idea that those who have greater pain might have retained more function rather than less after a brain injury. This seems counter-intuitive. I think of it this way: If tissue is generating pain, then it proves that it is alive. So more pain might mean more tissue that hasn't died and therefore less loss of brain performance.

As for what you do about it. I would say - Do everything you can. So, vestibular therapy, if you have a problem in that area. Chiro/neck therapy if that might improve some aspects of your situation. But if all that fails, it doesn't mean that there is nothing wrong with your brain just because you can still use it to do things well even though you lack mental stamina. Lack of mental stamina is surely not coming from the neck. So, you also should be thinking about what you can do to alleviate the stress on your brain. Also, I think that medication just for pain should be considered. So also contact a pain specialist, if you can find one, and try drug treatments such as gabapentin, pregabalin and amitriptyline.

I have tried pregabalin and it has helped to make the pain a lot milder. I am still experimenting with dosage. At the moment 125 mg, three times a day.

Good luck to all who have this problem.

CS