"Surprising Concussion Myths and Facts"
 

So I found this article titled "Surprising Concussion Myths and Facts" and it addresses a lot of the common misconceptions about concussion injuries.

I am sure that most people on this forum have this knowledge but new people might be interested in this:

http://www.sciencedaily.com/releases...0329170220.htm

-Glasshead

This is good. I found it last week. Later I could not remember where I read it to post the link to NT.

Thanks Glasshead

Question for Mark
 

Hey Mark, I liked that article, too.

Question, though...a little while back I put forth a theory that at least some of the damage from a brain injury might not be physical. I used the analogy of a virally-damaged computer hard drive, where there is no physical damage per se, but extensive alteration of the programming.

You seemed to assert that the damage must be purely physical, a matter of Diffuse Axonal Injury, and only undetectable due to the current limitations of our scanning technology. This article seems to support my theory, in that the aberration can be process-related rather than structural in nature. Any thoughts?

Here's the paragraph in question...

A normal CT scan rules out a concussion. [FICTION] "A concussion results from a neuro-metabolic event brought on by the trauma," Hummel said. "Simply put, there is an imbalance of the needed chemicals or fuel that helps the brain function when an athlete is concussed. That's not a structural injury, so a CT scan won't pick it up. CT scans can only view structural damage."

@Kenjhee

It has been known for quite some time that the damage done to the brain is more than just diffuse axonal injuries.

The metabolic cascade mentioned by the article is happening directly after the head injury and continues to do damage in the weeks following recovery.

In the past people believed that this was completely reversible and had no permanent effect on the brain. Furthermore it was believed that no structural damage was done to the brain when having a concussion.


Today we know this not to be true. The damage can be split up in three main categories which can all be diagnosed with the right equipment.

Structural; DTI, MRI, CT

Metabolic; fMRI, SPECT, PET

Funktional; MEG, EEG, BAEP

Structural damage is macroscopic damage to the brain in white and gray matter areas.

Metabolic damage is damage to the brain-blood barrier, vasoconstriction/dilation of capillaries and damage to astrocytic cells.

Functional damage is the change in brain activity and electrical impulses in the brain caused by a disruption or change in action potentials.


These three kinds of damage are all interconnected on a deeper level. Metabolic damage results in changed brain activity and so on...

When we say that people suffer from PCS, we don´t talk about a specific kind of damage or underlying issue but a whole range of possible deficiencies in the brain. So diffuse axonal injuries are only part of the problem and not the entire

syndrome in itself. If only it was that easy :)

I hope this clears it up, if not, just ask away.

-GlassHead

This is very helpful, thank you. Although I have battled medical problems since the accident 36 years ago, I've only been studying the brain itself for a couple years.

There are a number of different mechanisms. The initial injury causes a cascade of chemical events plus cellular events. The brain identifies the damaged cells and after a brief effort to allow for healing/metabolic correction, tRNA (transmitting RNA) is released causing the damaged cells to die. This continues until there are clean margins, so to speak, taking a term from cancer surgery.

The nutritional therapy many of us recommend helps basically in two ways. It provides the substances that allow and/or encourage the cells to function properly. The B-12, folic acid, D3 and some other supplements help the blood-brain barrier to strengthen.

The complexity of the metabolic processes in vitro ( live cells in a test tube or petri dish) are understood to a point. The specific in vivo (in the living body) process malfunctions are hard to identify. They can identify the metabolites of malfunctioning processes and the proteins (tau and others) that are problematic and erroneous neurotransmitters but not tie these malfunctions to an individual patient's brain. This is part of the reason for the 'Try this drug and see if it helps' treatment.

The software problem, so to speak, is due to either axonal or other cellular damage limiting the proper transmission of signals or failure of neurotransmitters to properly transmit the signals. The 'code' is directly written into the neurons. It is not loadable code that can be unloaded like computer code. It does get moved as the brain reorganizes and consolidates the data.

If you have ever watched a hard disk defragment and compress data, this happens each night during sleep. Information goes from immediate memory to short term memory to long term memory.

The processing of this data can get messed up by excessive adrenaline/epinephrine-norepinephrine causing the cellular processes to speed up. This data can also get messed up by faulty gating. Think of this as a traffic cop telling the data where to go and at a particular speed. In some injuries, different areas of the brain will operate at different speeds due to cellular damage or inadequate blood flow.

For example, my neuro can see that my brain processes incoming stimuli at a very slow rate and allows this data to pass through the gating process with haphazard controls. This means that I do best by limiting the amount of stimuli that my brain has to process. Think of this as if I am artificially gating or limiting the information so that it does not need to rely on the brain's gating mechanism to keep the processes under control.

There are many permutations of the various malfunctions that make it next to impossible to fully diagnose the brain's struggles.

Anybody who tries to make a definitive diagnosis is just making educated guesses. That is why individual symptoms are treated individually. There are not global treatments that can effect the many different injuries with a single therapy.

The CBT (Cognitive Behavioral Therapy) can be effective at lessening the overload and out of control thought processes that feed the cascade of other events.

Now, I have over done this topic. I even get to the point of confusing myself as I try to keep my thoughts organized.

@Kenjhee

If you are interested in the metabolic cascade following a concussion I recommend reading this article that takes an in depth look:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC155411/

Also if you have a general interest in studying the brain, I recommend reading the book "The Other Brain". It focuses on the often overlooked glia cells and how they relate to the general functioning.

I found the book very exciting and it is not a hard read.

http://theotherbrainbook.com/home.php


-GlassHead

Glasshead, thanks for the book info!

Another great book/reference is: Concussive Brain Trauma (Neurobehavioral Impairment and Maladaption). I am slowly reading the second edition.

It is not a real easy read and with 747 readable pages (total of 867) it will take some time. Especially if you read it like me 15-20 minute segments and re-reading parts over and over.

I really need to have it on tape lol.

But that being said, there is a lot of good information in there and I got mine on Ebay much cheaper than it normally sells for.

@HeadStrong

Thx for the info on that book. I really want it, but wow the price is high...

The cheapest I can get it for is 167$. Guess I have to wish for it at my upcoming birthday :)

There is a Second Edition of Concussive Brain Trauma that was published just last September, 2011. It is less expensive and hopefully includes reference to the research done since the First Edition was published in 2000.

Since it is new, there are no used copies available yet. But, $107 is far more affordable that $176

Here is the Amazon link :
http://www.amazon.com/Concussive-Bra...dp_ob_title_bk