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-   -   Questions about Concussions (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/258510-questions-concussions.html)

powerblackwolf 12-05-2023 09:28 AM

Questions about Concussions
 
I want to apologize first for the recent flooding on the TBI section of this forum. It seems that I have a lot that I want to know, and after reading through some of the previous posts, I now have some clarifying questions.

I want to preface this by saying I am in no way anxious or currently worried about any subconcussive/concussion impacts. As of late, there have been no flare-up or increased symptoms to make me feel this way.

The questions:

1) What causes a sensitivity to bumps/jolts/jerks?
I was under the impression that it was from Concussion Anxiety Syndrome, and that people who were experiencing a reemergence of these symptoms had them because of anxiety. I also thought that since whiplash can be caused by 2-4Gs, maybe a bumpy ride or walking down a steep hill is causing aggregation of the neck, or even a new whiplash injury. I know that bumpy rides cannot cause new concussions unless there is an impact. I believe I’ve also read somewhere in extremely rare cases, this may be discredited if the road is extremely, vigorously bumpy.

2) When do bumps/jerks become dangerous?
I am in the understanding that for a person with only a few concussions, there is no situation in which they would damage the brain and only rarely, strain or re-injure whiplash. I have also read a few posts made by Mark about how simple everyday actions, such as shaking his head ‘NO’, is able to give him a new concussion. I realize that this may be in relation to his many injuries. I just wonder at what point does something like knocking your head on an overhead counter go from an aggregation of symptoms to a full, new injury?

I know that it takes a lot of force to cause a concussion (60-120Gs). I have wondered if that remains the same for people with a few concussions, and when we say that it “becomes easier to get concussions” for these people, do we mean that it remains in that threshold (60-70Gs) or falls lower than that (below 60Gs)?

I promise that these are not questions meant to aid me in looking for symptoms. Simply, I want to know for educational purposes, and so I have the tools necessary to know whether an impact would be damaging or not. I just realized that while reading the forums, I wasn’t fully grasping these concepts. As we know - knowledge is power.

Thank you so much for your time.

Mark in Idaho 12-05-2023 02:03 PM

powerblackwolf,

You are reading some very OLD posts before I understood about upper neck injuries and vestibular injuries and how they can mimic concussion symptoms.

First, stop doing research. Doing excessive research is a manifestation of anxiety/OCD.

I was one of the first on this forum to start discussing the upper neck issues that were not discussed by the medical specialists until 5 years ago or so.

There are a few things that can cause symptoms.

1) PTSD flashbacks are a common occurrence. The brain remembers the time when the severe jolt caused symptoms. When the person starts focusing on head movement issues, the slightest sensation of head movement can trigger a replay/flashback of these memorized sensations and thoughts.

I have not even bumped my head in years but when I see somebody bump their head on TV, my gut clinches and I experience other flashback symptoms. I have similar reactions to seeing somebody injure their fingers or hands. I pull my hands in to my chest/belly. Guys 'feel it' when they see another man impacted in the groin....... These are all memorized responses, designed to be self-protective.

2) Jolts can trigger inflammatory responses without there being any physical injury, just strains of soft tissue.

3) Jolts/bumps can trigger upper cervical strain, vestibular issues by displacing the inner ear crystals, even just for a moment, disrupt vision in various ways, disrupt balance by anxiety responses conflicting with the communication between the eyes and vestibular system.

4) Jolts/bumps can be s surprise and cause a startle response. This can be alarming from an anxiety perspective or it can be disruptive to a train of though and cause confusion.

5) There could actually be enough trauma force to cause a real physical trauma. That is limited by the G forces experienced.

The vast majority of triggering jolts and bumps are from the 1-4 issues.

As Bud said long ago... As he recovered from his severe brain trauma, he had to learn to compare his reactions to jolts and bumps after his TBI to how he would have responded before his TBI.... That pot hole jolt would have been annoying before his TBI but it would not have caused any symptoms. After his TBI, he would react to that pot hole jolt until he reminded himself that pot hole jolts were never a problem before his TBI.

There has been a lot of research about increased risk of injury from a subsequent impact. It proves that the brain suffers very minimal if any loss of tolerance for bumps after it is given time to recover from inflammation and physical neck issues.

Second Impact Syndrome has nothing to do with increased sensitivity to movement from subsequent impacts. SIS relates to how a brain responds to serious impacts when it has not regained the ability to properly maintain cranial fluid pressures after a previous serious impact that disrupted the brain's ability to regulate cranial fluid pressures and flows.

powerblackwolf 12-05-2023 02:46 PM

Mark In Idaho,

As always, thank you so much for your considerate and thoughtful responses. It is greatly appreciated.

I will try to dial it back on the research. Ever since starting to learn about the sciences behind brain injuries and how they are impacted by a concussion, I have felt a return of some happiness. I have a deep love for sciences, and I think that I was finding some purpose in studying what I can about this new, interesting topic. But, I also completely agree that the research can be an example of anxiety/OCD, especially with how addictive it has become. There is so much to learn, perhaps too much, that I am forgetting about other activities that I could be enjoying!

I understand what you are saying about bumps and jolts. It is interesting how our perception of these things change after such an injury. When I become frightened after stepping off a stair too hard, I have found some benefit in trying to alter my thinking from “was that a concussion?” to “wow, that was a rough step!” and moving on. This must be what Bud has done, too.

As for the second question - I see. So, regardless of how many concussions one has, the brain becomes no more vulnerable to injury at lower forces? I wonder where the idea came from that it becomes extremely sensitive. So many people must be misinformed about that, seeing as it is such a prevailing theory.

I previously tried to find some more information online about Concussion Anxiety Syndrome. I wanted to send it to someone who was interested in understanding what is happening with me. Other than the work of Dr. Cameron Marshall, it seems that there is essentially no research done on the topic, at least that is easy to find. It is a shame that the knowledge we have on concussions is so limited, and there is so little information out there that could help better inform us.

Mark in Idaho 12-06-2023 12:09 AM

powerblackwolf,

I actually coined the term Concussion Anxiety Syndrome many years ago as I tried to help people on this forum. I have promoted the term to experts in hopes somebody would do some study. Others have slowly started to consider CAS as an issue, whether they use the term or not.

One study does show that 80% of people who experience prolonged struggles have a pre-existing history of anxiety and/or depression.


The idea that concussions combine to become easier to sustain was likely a result of the many people who develop symptoms from lesser bumps, whether those bumps are whiplash, anxiety triggers, or startles/annoyances. All of these non-concussions can cause similar symptoms

powerblackwolf 12-06-2023 10:02 AM

Ah, it all makes sense now.

As I have began to incorporate anxiety into the way that I perceive concussions, it has started to make more sense to me. Part of the reason is because I do not see why anxiety and prolonged stress would not affect the brain in such a way that it wouldn’t cause a PTSD response. Other than the simple fact that the brain has spent thousands of years evolving and refining the ability to recognize threats, whether these are old or new, there are many people such as myself who can connect these instances with past experiences.

I recognize it primarily in the way I interact with parents. When parents scream at their kids, there are many times where I am unable to fight the urge to physically hide. The depersonalization and derealization that I have in these circumstances are undeniable. To me, Concussion Anxiety Syndrome makes complete sense.

I have heard many times that people who suffer from anxiety/depression also have low-grade inflammation, regardless, and how cortisol levels rise when the ANS is no longer as capable of regulating stress. It is interesting how the parasympathetic and sympathetic nervous system become unbalanced. I have wondered if anxiety sufferers have a somewhat dysfunctional autonomic nervous system anyway, as I have always felt locked into this state of “fight/flight.” It makes CAS truly harder to overcome.

This is an interesting article that I have read. You may have seen it already, but I thought it was very informative.

Neuroinflammation-Associated Alterations of the Brain as Potential Neural Biomarkers in Anxiety Disorders - PMC

I hope at some point, more research can be done for CAS. It is a shame that only Dr. Cameron Marshall seems to be presenting this information to his audience. It is truly an interesting theory, and many of the people I have talked to about it feel the same.

Mark in Idaho 12-07-2023 02:38 AM

Just as some people are quick to raise their anxiety level, some suggest that some people have a sensitive inflammatory response.

One part of the fight or flight response is turning off the sensory filters that usually reduce stimulation that makes it to the cognitive and executive parts of the brain. Many TBI sufferers have suffered damage to this sensory filtering gate. We live our lives in an over-stimulated state until we learn new ways to reduce over-stimulation. I struggle to drive because my brain is constantly trying to resolve all of the fast moving objects.

We can reduce anxiety by reducing stimulation in our environment. No caffeine. Reduced auditory stimulation. Some even need reduced visual stimulation, such as less visual stimulation on the walls.

As we experience over-stimulation, toxic waste can build up in our brain tissue. If we do not get quality, restorative sleep, those toxins never get flushed or drained out. Proper quality sleep is the most important need we have.

I never get in bed and try to fall asleep. I wait in a quiet state with low stress visual and auditory stimulation until I'm starting to fall asleep and quietly get in bed. I usually fall asleep in just a few minutes. I had to learn this skill. It took me 2 years to figure this out.

powerblackwolf 12-10-2023 01:28 PM

Yes - I have read briefly some of the information about hypersensitivity in the immune system. The articles/podcasts said some do the same things you just did, about how it can be beneficial to remove “unnecessary stimuli” to lower stress and anxiety effects. It did not mention how that can impact sleep or how sleep removes toxic waste, however. That information is incredibly good to know.

One thing I wanted to ask is what other things have you done (other than sleep posture and icing) that helped to improve your neck?

This response took a while because I realized that I need to get more “neck-conscious,” as I have been calling it. I have a tendency to whip, jerk, shake, etc. my head during conversations or moments of excitement. After a flare-up of even worse symptoms a few days ago from shaking my neck/twisting it during a conversation, it revealed to me two things. Yes, my symptoms are mainly stemming from my neck. I also need to learn to be aware of how I am moving my neck during this recovery period. With how sensitive this part of the body becomes during concussion/whiplash, it is a great surprise to me that there is less information on this, too.

I should be seeing my neurologist/PCP in a week or two. That is when I will try to get to that PT you recommended, or spinal/chiro doctor for GERD.

Along with icing and improving resting posture, I’ve taken to cold baths to reduce inflammation. I allow myself to float at times, similar to how we treat joint pain in arthritis. It helps.

Thank you.

Mark in Idaho 12-11-2023 04:49 AM

To start, my PT did gentle traction with manual mobilization. I struggled to find a good upper neck chiro. The NUCCA chiro was a crook. There were no good Activator chiropractors here.

My PT also did myofacial release, trigger point, and some other hands on treatments.

powerblackwolf 12-11-2023 09:47 AM

Thank you! I’m writing those down. I’ll look for those, thank you so much for your kindness and patience with me/my questions.

davOD 12-11-2023 10:54 AM

Quote:

Originally Posted by powerblackwolf (Post 1303963)
Thank you! I’m writing those down. I’ll look for those, thank you so much for your kindness and patience with me/my questions.

Its a very long road you are on. What works for one may not work for another. Just hang in there, keep trying, and dont give up. Quitting is the easiest thing you can do, then you let in all the negatives.


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