My neuro mentioned that concussions do not cause any organic or structural damage to brains.

Even if it does not show on the MRI, can there still be damage?

Doesn't that damage contribute to the possibility of second impact syndrome/ multiple impact syndrome?

How is the shearing of axons involved in this?
Any opinions? Thank you.

That neuro is dead wrong. Just because the damage is not imageable on normal grade CT or MRI does not mean the damage does not exist.

My neuro knows quite the opposite. Some time ago, the University of Utah football team was given a research grade MRI with a 6 Tesla magnetic power. This MRI was able to image microscopic damage. The researchers started using it to research concussions suffered by the football team.

The concussions were very evident in the MRI images. After doing this on the football players, the coach finally decided to stop letting the players be imaged. The players were becoming paranoid of concussion injuries and it was effecting the intensity of their play. They turned the MRI over to the Psychology Department.

Eventually, the Psychology Dept ran out of funds to maintain the MRI coolant. The super conducting magnetic coils are cooled with liquid helium that is expensive to maintain. This caused the magnetic coil to overheat and be damaged beyond repair.

So, yes, there is imageable organic damage caused by concussions. It just requires a very high power MRI.

The other way to image organic damage caused by concussion is with properly operated qEEG equipment. It requires computer software to show the brain wave form that signify the damage. The use of qEEG to diagnose concussion has been fought by the medical industry and insurance companies despite the 97% accuracy.

Another way to diagnose the organic damage from a concussion is by measuring a protein. There are different proteins that have been studied in this area. The first to be identified was S-100B as compared to C-tau levels. Other proteins are c-myc protein and C-Fos protein.

None of these tests has been established as an FDA approved diagnostic procedure. The clinical trials are just too expensive to get FDA approval of these diagnostic tests.

Regarding organic brain damage and Second Impact Syndrome and Multiple Concussion Syndrome.

Second Impact Syndrome is when the recently concussed brain has lost some control of its ability to properly regulate intracranial blood pressure. This weaken ability is then challenged by a Second Impact that further damages this function. The failure of this system allows the blood pressure to exceed the brain tolerance levels, sometime to the point of herniating the brain into the brain stem canal.

This invasion of the brain stem's space can cause death due to a failure of the autonomic nervous system. Regulation of breathing and heart rate is lost resulting in death unless life saving measure are taken immediately.

Snow boarder Kevin Pearce came very close to death due to suffering two serious concussion within a three week period.

Multiple Impact Syndrome is an accumulation of damage to brain cells, neuron, axons, dendrites and even blood vessels that leave the brain in a weakened state that is beyond the brain's ability to accommodate. The progression into MCS is like trying to keep a marble rolling around on a board. As the marble rolls (a concussion) you try to move the broad to keep the marble from dropping onto the floor. At first, the marble starts rolling very slowly and is able to be kept on the board. As time goes by, attempts to keep it center start to fail due to fatigue. Eventually, that fatigue cause the marble to drop to the floor. Voila', You have Persistent Post Concussion Syndrome (PPCS) or Multiple Impact Syndrome.

This last example of trying to keep the marble balanced is like trying to avoid the stresses and other triggers that slow recovery. In the very early stages, the effort is much easier to handle. After a few more concussions, the effort become next to impossible. Welcome to my life......

With MCS or PCS, the goal is to learn skills to help manage the symptoms and work-around the dysfunctions and disabilities.

Now, I will turn off the fire hose.

The Thanks! button did not seem to be enough for this answer.

Thank you Mark!

I agree with Mark whole heartedly; I was actually waiting for him to reply to what you posted about your neurologist's beliefs because he can include so much more information about it than I could.

There are new studies with something called a Diffusion Tensor Imaging to help determine what's going in inside someone's brain after a mTBI. It measures the white matter, or axonal damage or something like that.

http://www.ninds.nih.gov/news_and_ev..._biomarker.htm

The CT and MRI are not adequate tests to indicate mTBI and often even MTBI.

I actually asked for it when I was still really bad off over a year ago and even my neurologist (who teaches neurology at USC) didn't seem to be aware of the studies or what I was actually asking for. But my communication skills were very poor and my cognitive functioning greatly degraded at that time so I'm not sure I was able to ask in the right way - My stepmom typed it out on a piece of paper with a lot of other concerns we had and I brought it to her and pointed to it and she thought it was a request for an MRI and I wasn't able to clarify because I was doing so poorly.

Frankly, I don't think your neuro knows what they are talking about and I hope you get a second opinion/find another neurologist.

I was tempted to mention Diffusion Tensor Imaging but held back. It is not widely used yet. If the MRI facility understands the technology, it can be helpful. Many of these imaging system are dependent on a good neuro-radiologist to set up and then read the images.

Interesting information here. i have a question, though. Is is possible for there to be functional damage from an injury without actual physical damage? Perhaps the brain is rewired wrong post-trauma, or an area of neurons simply shut down?

A gross analogy would be what a software virus might do to a computer hard drive. There is no physical damage to the drive per se, but the programming is so altered that the computer can not even run.

I will attempt to correct your premise. You can have damage that is not imageable because the damaged cells have been absorbed into the blood stream. Or, the damage is just too small. A focal area of damage will result in a weakness in the function supported by that area. Some functions can 'rewire to other areas. Some are restricted to a specific type of neuron with not enough reserve neurons to rewire through.

It does not take long for the cells to break down and be absorbed if there is circulation to carry away the residue..

The other damage that is not physical would be a build up of toxic waste products. Poor circulation can leave the toxic waste products in place such that there needs to be an improvement in blood chemistry/nutrition to help the toxins clear the brain.

Some literature tends to support that the brain is the last system to clear of toxins since it does not have the same like of lymphatic system as the rest of the body. Either way, if the body is clogged with toxins, the brain is likely clogged.

Stress causes many of these toxins to build up. Lack of proper sleep also causes these toxins to build up. Poor circulation is just as bad.

I hope this is making sense.

btw, The brain does not rewire in a way that is hap hazard. It has coding that prevents this from happening. If an attempt at a connection is wrong, the connection will be rejected. I have actually watched this microscopically in-vivo. (in a test tube or petrie dish with live brain cells) Very interesting. The attempts are hap hazard but the connections are not.

If the rewiring is to a proper type of cells, axons, dendrites, etc. then the connection will become complete and move on to another attempt. The multitude of permutations of these networks is vast so it can take magnitudes of these connections before a fully functioning neural network is established.

When Gabby Gifford goes through her therapy, she is slowly pushing these networks forward. They will not establish unless there is information to pass on. The progression is slow and painstakingly tedious. Sort of like beating a path through the wilderness. One needs to walk that same path over and over before it starts to become recognized as an established path.

Hang in there. Just keep moving forward even when you feel like you are not going anywhere further. As you continue to beat down the path you have already walked, you can start taking steps into uncharted territory.

This is how a baby's brain slowly establishes these same paths.

Remember, it has taken 10 to 20 years and more to just get a mature set of paths throughout the brain. A new path does not get established over-night.

Are you talking to me or the OP? I was not making a premise, I was asking a question.

Mark, I found your entire post fascinating. Do you know of any thing that might help the brain to clear toxins out in a faster or more efficient manner?

Some think it helps to get good lymph massages. The idea is that clearing the lymph system reduces the toxic load in the blood allowing the blood to be more efficient at carrying away toxins. Lymph massages may cause a negative reaction in the short term as the body tries to clean up the lymph waste. Continuing to clear the lymph system eventually clear the body.

Some do an organ cleanse. These can be done by consuming some nasty concoctions. I have never done one but know others who do them yearly or even more frequently.

I have just stayed with my supplement regimen. It does the same by empowering the body to work better. The anti-oxidants are a big part of the process. I am not big on the 'only natural or herbal' concept. the concentrations of beneficial nutrients is too hap hazard.