[Minimac]

Okay so I've wasted a lot of time searching for answers on mTBI and the healing phase. It's left me rather confused as to whether or not you will fully go back to your old self capable of the same potential regarding concentration academics, thought patterns, personality - pretty much anything you can think of.

I presume I had a mild concussion 10 years ago, based on the simple fact that I didn't feel nauseous or vomited at all. What my question is, does everyone vomit if it's more serious than a mild TBI? Do some people not feel nauseous or vomit even if they have suffered moderate to severe brain injury, and can you suffer such long term damage even though your symptoms lasted a very short amount of time like some hours?

Some people claim you recover fully, 100%, having a pristine brain again. So this leaves me wondering what type of damage is going on in a concussion. I know it's to do with a chemical reaction killing off neurons and possibly shearing axons. But... They say that these axons will reconnect with time. So is the damage really only the death of brain cells/neurons? If so, this happens all the time and it wouldn't be such a biggie to me. Since some also state it only affects your brain capacity, which I believe to be the death of neurons, I find it hard to believe that you can be invisibly impaired from one single concussion.

And then there is people who don't use the term "recovery" apparently, rather they use "compensation" since, according to them, the brain repairs itself by balancing neurons and hence leaving it at permanent altered along with restructured state of mind. So if this change of function in the brain doesn't affect you, it must be because the brain compensates all the time when neurons die of natural causes? Aka aging.

It seems hard to get a satisfying clear answer on this, even from experts...

[Mark in Idaho]

The reason these answers remain unanswered is because nobody knows the answers. They are all using anecdotal evidence or loosely based research.

One researcher found that there is never a 100% recovery. There may be perceived 100% recoveries but those individuals will manifest symptoms when their brain is under stress.

There is no connection between vomiting and concussion severity. I never vomited after any of my concussions, including the one that left me unconscious for 30 minutes.

Your whole third paragraph is full of misunderstandings. You take as fact things that at best are only professional opinions and conjecture. In the vast majority of cases, the patient is considered recovered when they stop complaining and asking for treatment or have been allowed to return to play. The quality of life after concussion research is very weak although it does show that those with prolonged symptoms tend to have a noticeably lower quality of life.

What is the point of your question ? Are you trying to learn what your own prognosis is ?

The slow aging process does not effect the brain at anywhere near the intensity of a concussion.

[russiarulez]

I never vomited after any of my concussions, but had a friend who sustained a very serious concussion and had all the typical signs for a couple weeks (vomiting, vertigo, sleeping all the time, fatigue, etc) and he recovered in about a month no problem.
I had my last concussion about a month after his and all I had was a bit of a headache in the afternoon. Little did I know that two years later I would still be dealing with PCS.

I've been thinking more and more about my cognitive abilities before my last concussion that caused PCS.
I've been noticing that in recent years it was becoming harder and harder for me to retain new information, concentrate in meetings, and I didn't feel as "sharp" as I used to in college and when I started my full time job. At the time I dismissed it as part of an aging process or maybe just not getting enough sleep or something (I was in my mid 20s at the time).

I used to get mentally exhausted at work even though the work load was less that it used to.
A lot of times I would snap at people or break down emotionally without much reason and thought it was weird.
I also went through the same exact "eye pain when using computers" that I have now at some point in the past that at the time I contributed to working too much (i'm a software developer).

Now after everything I know about concussions I'm thinking that I've had lingering PCS symptoms after a few of my past concussions that I ignored and this last one just did me in.

A word about recovery from my own experience - this last concussion - after about 3 months I started to feel great and thought I have recovered. I ended up overdoing it one weekend and this put me into a tailspin that I'm still dealing with two years later.

[ProAgonist]

Originally Posted by Mark in Idaho

The reason these answers remain unanswered is because nobody knows the answers. They are all using anecdotal evidence or loosely based research.

One researcher found that there is never a 100% recovery. There may be perceived 100% recoveries but those individuals will manifest symptoms when their brain is under stress.

There is no connection between vomiting and concussion severity. I never vomited after any of my concussions, including the one that left me unconscious for 30 minutes.

Your whole third paragraph is full of misunderstandings. You take as fact things that at best are only professional opinions and conjecture. In the vast majority of cases, the patient is considered recovered when they stop complaining and asking for treatment or have been allowed to return to play. The quality of life after concussion research is very weak although it does show that those with prolonged symptoms tend to have a noticeably lower quality of life.

What is the point of your question ? Are you trying to learn what your own prognosis is ?

The slow aging process does not effect the brain at anywhere near the intensity of a concussion.

I see you claiming here around in this forum here that the brain never recovers 100% from a concussion. Do you base this saying just on one study? One study isn't enough to conclude anything. I'm sure there are studies with conflicting evidence as well.

If the loss of brain cells is very minimal in mild concussions, why can't the person make a good recovery?

I do agree, though, that it's the more severe concussions that actually cause some irreversible damage. But we need more studies to conclude whether you fully heal or not.

[Mark in Idaho]

What I said, is the recovery may appear to be 100% but when under stress, symptoms can appear. This has been well studied. This does not mean that a person with PCS can't return to their previous life, just that they may experience a reoccurred of symptoms during times of stress.

The simplest example of this is once concussed, the brain will be more sensitive to the next concussion. This shows a residual injury/limitation. This is a well known issue.

The study looked at cognitive performance without stress and when under stress and found those with a concussion history showed a statistical reduction in cognitive performance when under stress yet those without a concussion history did not suffer this level of cognitive performance decline when under stress.

Although not as comprehensive, a study using qEEG was able to show that 97% of those with a concussion history showed residual symptoms.

As I have always said, There can be an appearance of a 100% recovery. One expert has challenged the medical community to record any possibility of a concussion on medical records so that symptoms that show up later can be properly understood.

What is so hard to understand about this issue ?

[Minimac]

My interpretation of your answers leaves me to conclude then, that there is a lot of conflicting research on this, as thought out to be. I am glad from hearing though, that impairments only can arise during stress. So I guess during exams and stuff, it could have a noticeable effect? For example I notice that if I study intensely for a day, my head gets extremely hot for some reason, not really sure if this is a normal reaction to stress, or PCS.

[Mark in Idaho]

The research is not conflicting in this. There is research being done to find ways to spur the brain into a healing mode because there is not a natural healing system that can overcome all the damage done, even the very minor damage.

Why do you think there ought to be conflicting research ?

I did not say "that impairments only can arise during stress." I said that is when they are likely to arise. There are many other factors at play. Age related brain changes can also cause concussion/mTBI symptoms to arise. They can be expected in the late 30's to mid 40's for many people.

Plus, stress has many different forms.

[ProAgonist]

Originally Posted by Mark in Idaho

The reason these answers remain unanswered is because nobody knows the answers. They are all using anecdotal evidence or loosely based research.

One researcher found that there is never a 100% recovery. There may be perceived 100% recoveries but those individuals will manifest symptoms when their brain is under stress.

There is no connection between vomiting and concussion severity. I never vomited after any of my concussions, including the one that left me unconscious for 30 minutes.

Your whole third paragraph is full of misunderstandings. You take as fact things that at best are only professional opinions and conjecture. In the vast majority of cases, the patient is considered recovered when they stop complaining and asking for treatment or have been allowed to return to play. The quality of life after concussion research is very weak although it does show that those with prolonged symptoms tend to have a noticeably lower quality of life.

What is the point of your question ? Are you trying to learn what your own prognosis is ?

The slow aging process does not effect the brain at anywhere near the intensity of a concussion.

Originally Posted by Mark in Idaho

The research is not conflicting in this. There is research being done to find ways to spur the brain into a healing mode because there is not a natural healing system that can overcome all the damage done, even the very minor damage.

Why do you think there ought to be conflicting research ?

I did not say "that impairments only can arise during stress." I said that is when they are likely to arise. There are many other factors at play. Age related brain changes can also cause concussion/mTBI symptoms to arise. They can be expected in the late 30's to mid 40's for many people.

Plus, stress has many different forms.

I understand what you're saying, and I've read the studies you're talking about.

But did you know that damage to nerve cells can be partial? And if the damage is partial, did you know that it can be fully recovered?

I recommend this short video about a teenager who suffered a severe brain injury, and was in coma for a few weeks. Two days after starting daily treatment with 20 grams of Omega 3, he woke up from coma. A few months later he returned to be fully functioning - and the doctors said he would never be able to walk again!

You can watch the full video here:

https://www.youtube.com/watch?v=TlsK9OSBqh4 (Length: 5:53 minutes)

Now, I also know about the stress tolerance that reduces with every concussion. You said something about it, and it's TRUE.

But who said it is irreversible? Can any researcher even say why exactly your tolerance to stress reduces? Is it the result of neuron partial/full damage or the result of neuroinflammation? Does it happen because a concussion imbalances your neurotransmitters and hormones?

In many cases, even if symptoms from a damage last for years, it doesn't mean it is permanent and irreversible. Some people, for example, never get the recommended cognitive rest for a while, so they carry their damage for years, never letting the brain some time to rest.

There is also the story of Dr. Michael Lewis, who treated an ex-soldier from the American Marine troops. This patient suffered from Post-Concussion Syndrome as a result of concussions caused during the war against Iraq. He had the Post-Concussion Syndrome for 7 years! This ex-soldier told Dr. Lewis that he was suffering daily headaches, his short-term memory was very bad and he suffered many other cognitive symptoms. Dr. Lewis recommended that he starts on an extremely high dose Omega 3 daily (in the article I've read they don't mention exactly how high the dose was, but it was probably around 20 grams per day or even more), and that's what he did.

The next time Dr. Lewis met with this ex-soldier, the ex-soldier told him that headaches resolved already on the 2nd day of the treatment and HAD NOT RETURNED SINCE. And that's after 7 years of PCS. He just got rid of the headaches completely. When he said his headaches were fully gone, I'm pretty sure he was also talking about stressful situations - because if these situations would cause his PCS symptoms to return, he would've mentioned it to Dr. Lewis.

There are a few more examples, but I think I've made my point. Sometimes, your body can surprise you, especially when it gets the right treatment. Or, if we use the analogue Dr. Lewis used about Omega 3 fats (EPA&DHA) and concussions - "If you have a brick wall and it gets damaged, wouldn't you want to use bricks to repair the wall? And omega-3 fatty acids are literally the bricks of the cell wall in the brain."

Please reply and tell me what you think about that. I would also like to hear from you an explanation about why exactly stress tolerance reduces permanently (if it's even known to you or to medical science).

[Mark in Idaho]

ProAgonist,

You are not understanding what I have said. None of the cases you present suggest 100% recovery. They do show very good recovery but not 100%. I am not trying to rain on everybody's parade about recovery. Everybody has a chance at a good recovery, just not a perfect recovery. There have been many examples of spontaneous recoveries like the comatose teenager with and without Omega 3 oil. Yes, the Omega 3 oil is a great help. That has been well demonstrated. The damaged brain needs the building blocks for repair. It helps the nerve synapses function and is needed for the nerve fibers. But, Omega 3 does not cause complete healing. There are many systems in the brain that need healing.

Some researchers believe the glymph system gets damaged and is slow to heal creating a weak process for clearing toxins and metabolic waste. Others are looking into ways to restore tau protein function. The myelin sheath that insulated the nerve fibers is very slow to repair. Does it repair to a weakened state ?

My point is to try to convince people to accept that they may have residual symptoms and to create and live a life with that in mind. Reducing stress, ending the risk of contact sports, eating healthy including supplementation, proper sleep, etc. all contribute to maintaining the highest level of recovery possible.

The issue we need to be aware of is simple. Do the subjects in the articles and studies recover to 100% or do they just recovery from very poor states to high functioning states ? In neuro rehab programs, the goal is to regain the ability to maintain ADL's (Activities of Daily Living). What many neuro rehab subjects consider a full recovery is the starting point for many with concussions. I have 30 or so friends and acquaintances who have gone through neuro rehab programs. Most of them have recovered to a condition very similar to those of us with PCS except with some residual motor damage or such.

Again, My point is to try to convince people to accept that they may have residual symptoms and to create or live a life with that in mind. People tend to get upset every time a symptom returns. The 'I want my life back' claim is disabling. This need to focus on the residual symptoms rather than learn to work around them and move on creates a self defeating problem. If your precuncussed life was built around risky activities and high stress environments and activities, returning to that will be difficult.

[russiarulez]

I agree with Mark. I don't think there's ever a 100% recovery.
I don't think it is possible to really measure just how much damage there is.
How would you know if the cognitive function slowdown five years after a concussion was caused by a concussion or it's just age-related? There are also other diseases that might cause similar symptoms to that of PCS.

When someone breaks a leg and then it heals, do we say that this person made a 100% recovery? I think not, since there will always be clear evidence of the bone breakage on an Xray and many people will experience occasional pains/discomfort as they get older.

I accepted the fact that I will have to give up some activities that I really enjoyed in the past (contact sports being a good example). It took me a long time to come to terms with this fact, but I really want to avoid getting another concussion in the future and going through PCS hell all over again.