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-   Traumatic Brain Injury and Post Concussion Syndrome (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/)
-   -   Post concussion head trauma vulnerability (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/200530-post-concussion-head-trauma-vulnerability.html)

Canadoc 05-06-2014 09:41 PM
Quote:
Originally Posted by Canadoc (Post 1067491)
Before I answer this question, I'm going to do a little research. There is plenty of information available on the internet these days. The problem is the quality of the info. In order to justify a recommendation, people sometimes quote studies that were either improperly powered to make specific conclusions because of sample size, were not randomized, had selection bias, etc...... Sometimes there aren't any properly constructed studies to answer a specific medical question and one has to rely on the best available evidence. I know little about HBOT and PCS recovery but will venture to see what quality evidence there is to justify such a cost. Stay tuned.

Canadoc
I had to answer your question over 2 blogs due to time pressures. Just a few comments on the other issues. I don't believe having a NATURALLY low cholesterol is of relevance regarding your potential for neurological healing. In other ways, this may well prove to be a significant advantage with regards to reducing your lifetime risk of manifesting symptoms of dementia later in life. I would trade cholesterol profiles with you in a flash!

Vitamin B12 is very important to maintain a healthy neurological system. Those who are deficient benefit from supplementation. Few would argue this point. There are differences in opinion as to what constitutes the ideal blood level. Your laboratory report would have the acceptable reference range. Does correcting a state of B12 deficiency accelerate healing after an mTBI or in an individual with PCS? Who knows! I have not been able to find any convincing evidence to that effect. It does make sense however to correct a deficient B12 state in order to avoid the other well documented neurological and hematological problems associated with low blood levels. I have equally not come across any evidence to suggest that supplementing a B12 SUFFICIENT individual provides healing benefits. Again, I would invite anyone with evidence to the contrary to share their insights and knowledge.

Just a final note on your low vitamin D levels. If you live in an area of the USA where sunshine hours were at a premium over the past 5 months or if you spend most of your waking hours indoors (or both), your vitamin D levels would have naturally fallen (unless you were taken supplements). You may wish to discuss with your doctor about remeasuring your levels during the summer. You might also want to inform yourself about supplementing with vitamin D during the colder months of the year as a rule.

Hope this info has helped. I wish to remind you that the above information is my own opinion and, ultimately, you should review any medical decisions with your personal physician. Cheers. Canadoc

nimrod4u 05-21-2014 10:29 PM
Hi Canadoc,

Thank you for the in-depth research and input on the aforementioned issues. I took them into account and adjusted my treatment accordingly.

Recently, I received some possibly life-changing news. Upon the suspicion of one of my doctors, I had some more blood work done. My IGENEX blood work results back as POSITIVE for Lyme disease.

It makes sense to me that Lyme is a major contributing factor to the inflammation in my brain and a major cause of my headache, fatigue, brain fog, and vestibular issues. Apparently, the Lyme bacteria lives in different fatty tissues in the body (in the brain, lymph nodes, joints, etc.), and the body's autoimmune response to the bacteria causes inflammation wherever the bacteria happens to be located. Looking back at my re-occurrences of post-concussion symptoms, I realized that nearly all of them coincided with swelling and pain in my groin lymph nodes and testicles. I visited many urologists over the years who couldn't find anything wrong, and just described the swelling as chronic idiopathic prostatitis.

In addition to Lyme explaining the lymph node swelling, I am convinced that Lyme is a primary cause of my symptoms because since starting antibiotics, my symptoms have gotten much worse. The worsening of symptoms was predicted by my doctors and is called a Herxheimer reaction. Basically, as the antibiotics kill off the bacteria causing Lyme disease, my body has a difficult time ridding the body of the dead bacteria which causes the worsened symptoms. For example, the first night after taking antibiotics, I woke up sweating profusely. Apparently, this my body trying to get rid of the dead toxins of the bacteria. Also, I have noticed that half of my face is very tingling after taking antibiotics (possibly related to bacteria dying which caused previously unnoticed bells palsy).

Now I am taking antibiotics, probiotics, detox supplements/dieting, and doing HBOT five days a week. In addition to promoting the growth of capillaries to regenerate brain connections, the HBOT is supposed to magnify the effect of the antibiotics and force out the Lyme bacteria that is deeply rooted in the tissues in my brain. While many of my symptoms are worse than ever (I am so fatigued that I am sleeping 12-16 hours a day now), I am convinced that the worsening in symptoms has been caused by the "Herxing" effect, and that this is a good thing for the long term. I feel like I am finally on the right path to recovery.

I know that the medical community is divided on treatment for chronic Lyme, but I am seeing a specialist and trying to absorb as much information as I can about the disease. Lyme can manifest itself in all sorts of weird ways, so I would encourage anyone who has experienced anything like me to explore Lyme as a possible cause of your symptoms.

Best wishes,
Nimrod

Mark in Idaho 05-21-2014 11:47 PM
nimrod,

I don't have the reference handy but years ago, I read a report that said studies show very low cholesterol increases the risk for dementia later in life. btw, I paid attention to this report because my father had historically low cholesterol despite eating fatty foods and transfats his whole life. He died of dementia at 78 with the physical fitness and heart of a 50 year old.

My mother is 89 and has had a 240 or higher total cholesterol for decades. Her heart has been strong.

Halfnelson 05-22-2014 08:21 AM
Quote:
Originally Posted by Canadoc (Post 1067956)
I had to answer your question over 2 blogs due to time pressures. Just a few comments on the other issues. I don't believe having a NATURALLY low cholesterol is of relevance regarding your potential for neurological healing. In other ways, this may well prove to be a significant advantage with regards to reducing your lifetime risk of manifesting symptoms of dementia later in life. I would trade cholesterol profiles with you in a flash!

Vitamin B12 is very important to maintain a healthy neurological system. Those who are deficient benefit from supplementation. Few would argue this point. There are differences in opinion as to what constitutes the ideal blood level. Your laboratory report would have the acceptable reference range. Does correcting a state of B12 deficiency accelerate healing after an mTBI or in an individual with PCS? Who knows! I have not been able to find any convincing evidence to that effect. It does make sense however to correct a deficient B12 state in order to avoid the other well documented neurological and hematological problems associated with low blood levels. I have equally not come across any evidence to suggest that supplementing a B12 SUFFICIENT individual provides healing benefits. Again, I would invite anyone with evidence to the contrary to share their insights and knowledge.

Just a final note on your low vitamin D levels. If you live in an area of the USA where sunshine hours were at a premium over the past 5 months or if you spend most of your waking hours indoors (or both), your vitamin D levels would have naturally fallen (unless you were taken supplements). You may wish to discuss with your doctor about remeasuring your levels during the summer. You might also want to inform yourself about supplementing with vitamin D during the colder months of the year as a rule.

Hope this info has helped. I wish to remind you that the above information is my own opinion and, ultimately, you should review any medical decisions with your personal physician. Cheers. Canadoc
Hi Canadoc,

I just thought I would let you know that you are not alone and I experience symptoms almost exactly the same as you.

If I raise my blood pressure (especially by lifting weights) this causes an increase in intra-cranial pressure which results in an immediate 'pressure' feeling in my head followed by cognitive decline for approximately 24 hours. Even something as simple as a bowel movement quickly brings on symptoms. I do not experience a 'head ache' though.

I have experienced this problem for 3 years now and with no improvement unfortunately. However, like you, if I take a course of steroidal anti-inflammatories my symptoms are completely eliminated and I return to 'normal'.

Considering the success of steroidal anti-inflammatories, what do you think this means?

My hypothesis is a permanent hypersensitivity of the brain (perhaps the meninges as you suggested) to increased ICP followed by immediate inflammation that lasts for a short period of time. The inflammation reduces blood flow in the affected area of the brain as well as cellular function. I am not sure if a neck issue is relevant in my case.

I wish I could provide a 'quick fix' answer but I think that recognising the issue is related to hypersensitivity and inflammation is a step in the right direction to some kind of treatment.

Lucky for you, at least you can avoid bringing on symptoms by avoiding raising ICP. Unfortunately for me, even taking a non-strenuous bowel movement causes the symptoms. So I'm just trying to learn how to cope with it as a permanent condition...

I'm always open to advice though.

Halfnelson

nimrod4u 05-22-2014 08:44 AM
Quote:
Originally Posted by Mark in Idaho (Post 1070909)
nimrod,

I don't have the reference handy but years ago, I read a report that said studies show very low cholesterol increases the risk for dementia later in life. btw, I paid attention to this report because my father had historically low cholesterol despite eating fatty foods and transfats his whole life. He died of dementia at 78 with the physical fitness and heart of a 50 year old.

My mother is 89 and has had a 240 or higher total cholesterol for decades. Her heart has been strong.
Mark,

Thank you for the message. When I have asked my doctors about my super lower cholesterol, most tend to shrug it off and say that they don't know of any conditions associated with low cholesterol. I think most doctors have this reaction because they hadn't studied it med school for whatever reason (possibly b/c having super low cholesterol is very rare). I see some articles online now suggesting that researchers are finding a link between low cholesterol and brain disorders like dementia and alzheimers. It appears that some cholesterol is necessary to perform critical functions in the brain on a cellular level. I've also seen some indication that low cholesterol may be linked to liver problems, thyroid problems, and mood disorders.

In light of this, I am making a conscious effort to eat a little more bacon for breakfast to get myself closer to the normal range. :)

I am also getting my blood work done the first week of every month for the rest of the summer to keep an eye on things.

Thanks for your input.
Nimrod

Canadoc 05-24-2014 07:16 AM
Quote:
Originally Posted by nimrod4u (Post 1070958)
Mark,

Thank you for the message. When I have asked my doctors about my super lower cholesterol, most tend to shrug it off and say that they don't know of any conditions associated with low cholesterol. I think most doctors have this reaction because they hadn't studied it med school for whatever reason (possibly b/c having super low cholesterol is very rare). I see some articles online now suggesting that researchers are finding a link between low cholesterol and brain disorders like dementia and alzheimers. It appears that some cholesterol is necessary to perform critical functions in the brain on a cellular level. I've also seen some indication that low cholesterol may be linked to liver problems, thyroid problems, and mood disorders.

In light of this, I am making a conscious effort to eat a little more bacon for breakfast to get myself closer to the normal range. :)

I am also getting my blood work done the first week of every month for the rest of the summer to keep an eye on things.

Thanks for your input.
Nimrod
Perhaps a little explanation might clarify some confusion about cholesterol and dementia. First off, dementia is an umbrella term that encompasses several types of diseases that lead to neurocognitive decline. The 2 most common are Alzheimer's dementia and vascular dementia. Although the outcome is quite similar, the mechanism of disease is very different. Whereas Alzheimer's involves the deposition of "amyloid-beta" plaques and tangles in the brain, vascular dementia stems from the blood supply to parts of the brain being choked off by "clogged" or damaged blood vessels. They can also co-exist.

Cholesterol particles exist in several forms in our bodies. Some of these particles promote the deposition of "plaque" inside the blood vessels and "clog" them up (low-density lipoprotein or LDL, very low-dendity lipoprotein or VLDL, etc). Some particles do the exact opposite and are protective (high density lipoprotein or HDL).

Generally, when people refer to their "cholesterol levels", they mostly talk about the "bad" cholesterol. It is this type of cholesterol that is lowered (diet, supplements, medication) in the hopes of slowing down the progression of cognitive decline in those who suffer from vascular dementia.

However, a LOW "good" cholesterol can also have implications regarding an increased risk of premature vascular or blood vessel disease. So doing things to increase your "good" cholesterol, if it is indeed low, makes sense. Regular exercise is one of several ways. Unfortunately, eating more bacon, as you proposed, just won't cut it!

Bottom line, find out which cholesterol particle is LOW. If it's the "bad" kind, then thank your parents for passing on good genes. If it's the "good" kind, then find ways to stay aerobically active among other things.

Hope this helps.

Cheers, Canadoc

bschmucker 07-07-2014 03:13 PM
Hi all,

Although I haven't posted much on this forum, I have been an avid follower learning along the way. I'm very blessed to have learned a lot from this site and have seen continued improvements. The concussion world is a ever changing confusing topic (pun intended :).)

Quick recap- My concussion was on Oct 26, 2013 playing rugby, I whip-lashed and hit the back of my head. I suffered from PCS for a little over 8 months now. Been through a number of symptoms including Depression/Anxiety/Headaches/Exhaustion/etc. I have never suffered like this and I have a new level of sympathy for others who deal with these same problems.

I'm close to having my life back to what it was pre-concussion. No more depression, I've been staying positive, no anxiety, and fewer headaches.

One thing in particular has been stressing me out. I haven't been able to work out. I'm not trying to max out lifts or become the world's strongest man, but slowly get back into having the ability to life (I've been starting with 1/10 the weight I used to lift). It's been a cat and mouse game. If I don't do anything I feel like I'm getting stagnant and losing weight/strength, if I hit the limit where I did too much it's an immediate 1-2 week set back.

I am wondering if anyone else has this same problem. It sounded like Canadoc mentioned his inability to lift without raising the ICP levels. I can relate, it feels like a throbbing headache and is definitely my brains way to tell me to take it easy.

I'm just looking for people who are dealing with this same type of problem and/or people who have been through this and saw improvements. What have you done, other than rest, to get back into this.

Thank you in advance for any suggestions or stories.

Continued healing to all on here, B.

Canadoc 07-11-2014 10:57 PM
good ol' head pressure with effort
 
This is the one symptom whose cause remains elusive to me. I've spent a lot of time thinking about possible mechanisms. I always seem to come back to the notion that there must be an acquired maladaptive response to handling rising intracranial pressure (such as the case with a valsalva manoeuver) in some people after a mTBI or that there is a heightened sensitivity to ICP even in the physiologic ranges. The other questions is whether the problem stems from the arterial or venous side of the cerebral vascular system, or both.

I have been trying to figure things out from the venous side given that the pressure is definitely related to straining. One of the things I'm trying to figure out is the adaptive response in a "normal" brain when someone in turned upside down for a prolonged period of time. In this situation, cerebral venous hydrostatic pressure rises quickly which must drive fluid out of the vessel and into the interstitial space of the brain. How does the brain cope with this fluid shift on the short term such that homeostasis is maintained? What leads to this homeostatic mechanism to eventually falter over time if the upside down position isn't eventually corrected? Perhaps there is similarity is what occurs after an mTBI. Just wondering out loud.
Anyone with theories?

greenfrog 07-12-2014 08:49 AM
My concussion doc is outstanding and, in general, he doesn't recommend weightlifting (beyond light-to-very-moderate weights). Too much strain on the brain.

And, of course, people in the acute phase of recovery should not be doing any lifting of consequence.

musicman 05-15-2015 07:09 PM
Totally relate to this thread!!
 
Quote:
Originally Posted by Canadoc (Post 1048353)
Hi everyone,
This is the first time posting a "thread" as well as the first time I've ever been part of an on-line forum, let alone any forum for that matter. I'm a family physician in Canada, and like most Canadians, enjoy playing hockey. Unfortunately, in 2006, I suffered a concussion during a hockey game which resulted in a prolonged recovery. After about a year, I was finally able to tolerate and enjoy sports again without inducing a headache. As you can imagine, I was forbidden by my wife to lace up my skates again (no argument).

In retrospect, I now realize I made 2 errors in recovery (wish I knew then what I know now). First, I quickly returned to work without much cognitive rest and pushed my way through long clinic hours. Second, I lifted a heavy article on day 2 post mTBI which quickly brought significant and instant head pain.

What has now become a permanent disability is an inability to strain or lift articles more than ~10 lbs without feeling a discomfort in my head. This discomfort eventually becomes pain if I persist with the strain or lift. The more intense the pain, the longer it takes to dissipate. With new head trauma (such as loghtly bumping my head on a shelf, running in my squash opponent....ie sudden deceleration), this intolerance to strain is magnified for a few weeks. Eventually it settles back to a baseline but never goes away. Essentially I am extremely sensitive to any increase in intra-cranial pressure(ICP) (physical strain--->increase venous pressure--->increase ICP. The problem is that it is now taking less force to temporarily magnify this phenomenon. I've recently had a second MRI specifically to rule out a head trauma induced Chiari-type CSF obstruction. Thankfully everything was normal. I've consulted local "concussion specialists" who can only come up with theories of meningeal hypersensitivity post injury with the consideration for medication dampen the pain during effort (which I'm reluctant to do).

The other phenomenon that now follows any head bump (and I mean just a bump), is a decline in cognitive stamina that slowly improves over 2-3 weeks. It's difficult to cancel patients who have been waiting so long to see you. So, against better judgement, I often will push myself cognitively through a days work. I now can appreciate that these changes (following repeat minor injuries) are both structural (at a cellular level) but also biochemichal (increased neuron vulnerabilty and cell dysfunction). What puzzles me is why the worsening trend over time.

Once I'm 3-4 weeks past a "head bump", I feel cognitively great again. I'm able to enjoy aerobic sports that don't increase venous pressure much or for long. In other words, I have no problems tolerating an increase in arterial pressure when I'm "well" (I can ride my bike but just can't lift it!).

I wonder if anyone else has been experiencing similar post-concussive symptoms and whether investigations have shed any light.
So I can completely identify with every post! I've been suffering with PCS since January of this year and it has completely turned my life upside down!! Canadoc have you made any more progress since this original thread? As in treatments etc... I'm particularly interested b/c your symptoms are so similar to mine and you also work in the medical field. I can say with out a doubt that Hyperbaric oxygen therapy has been the ONLY thing that has made any significant difference in my recovery. And I mean almost immediately, however I cracked my head on the hatchback of my van as I was unloading equipment for work and have regressed pretty significantly!! The minor bumps are maddening!! I went to hug an elderly lady at church and she came in a little too quick and that small bump just set me back even further. I was at a social function today telling people please dont hug me as Ive re-injured my head. Even thought about wearing a neck brace just so people would be more careful when they approach (we hug eachother down here in the South). I'm struggling with the fact that I might not be able to exercise the way I used to. (talk about anxiety and depression) At this point, I can't excercise at all, however I was making progress in the early part of my hyperbaric treatment which is now so much more frustrating since I am now back to balance problems, muscle weakness, brain fog, vision problems, cognitive issues, etc... Was considering Atlas orthogonal, but I've also read about that making things worse. Anybody with some experience with that type of therapy for PCS?


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