john,

First, don't waste your breath asking your neuro. As I said, he does not know the answer. Plus, what symptoms are you seeing the neuro for ? I thought your only symptom was occasional head aches. You said "Not just the single simple question "is 100% recovery possible" as I do know that, yes, doctors will usually say yes based on the patient's usual layman understanding." I don't think the patient's usual layman understanding has anything to do with how a neuro will answer your question. Even your doc with special training in concussions will say Yes. They do not know any different.

But, I expect you will keep asking this question so you can get a number of answers that agree with your opinion.

I take great exception to you terming my comments as only my opinion. I have been seriously reading the research for over 15 years. The research from the 70's was repeated in the 90's with the same result. As I said, even newer research with the latest and greatest diagnostic tools have confirmed the older research. The research is conclusive. There is no way newer technologies can disprove what has already be demonstrated. Newer technologies will not show the changes in qEEG/AEP/VEP to be erroneous. High Tesla MRI's can image the damage long after an perceived appearance of recovery. I am not adding the comment that the brain does not heal 100% as my observation. The studies make this statement in their scientific conclusions. It a study were to say less than such an affirmative statement, I would only repeat it as studies suggest, not studies state or studies show. And, scientific studies routinely make that distinction. Often, when they make a 'the study suggests' comment, they also comment about the need to study the issue further using a more refined study protocol.

Some of the long term symptoms of brain injury are in thought processes. A common one is called rigidity of thought. It is a thought process where it becomes difficult to over-rule existing thought processes. It can be compared to OCD like issues. Anxiety or a focus on a single issue is also a common symptom. In MY perspective, it APPEARS that you have not been able to accept comments I have made nor take those comments and apply them in a logical way to come to a conclusion. Now, you have taken that same comment and made it into an accusation versus an observation from my perspective.

Regarding nicotine, the fact that it is vasoconstrictive HIGHLY suggests that it can effect recovery that requires good blood perfusion. Research shows great value to getting good blood perfusion in the brain to recover from brain injuries. One of the key struggles the injured brain has is clearing toxins from injury and metabolic wastes. Only the capillaries supply blood to the individual cells. Larger vasculature is only for blood distribution. There are plenty of concussion issues needing research that make any research about nicotine out of the question.

HBOT imaging research is often used to promote HBOT for concussions based solely on the observation that HBOT causes capillary regeneration. They can image this capillary regeneration. They tie this capillary regeneration as important for concussion recovery based on the known need for good capillary perfusion. Logic would suggest that anything that reduces capillary perfusion as counter to optimal healing.

Regarding your other history. Your demand that I ignore that when answering your question is like the patient who asks his doctor if he will be able to dance after his leg heals. When the doctor answers "Yes," the patient responds, "Great, I never could before."

I am not making a judgement about your past. The fact that you overcame that period is a giant feather in your cap in my view.

btw, I do understand these issues. I lost an uncle and great uncle to alcohol. I have also read the research about how alcohol affects the brain long term. It is most damaging to the brain when abused before the age of 25, the younger, the greater the risk to the brain.

Doctors take medical histories because those histories matter. I am sure you have been taught the importance of getting accurate medical histories.

The reason I brought it up this last time was to emphasize how the brain changes how it functions based on things as simple as nicotine and alcohol. The neurotransmitters and multitude of chemical receptors in the brain can quickly become accustom to the presence of things like nicotine, alcohol, drugs (legal and illegal), sex hormones and related pleasure chemicals, and such. It is often extremely difficult to change how the brain responds to these issues.

It is known that PTSD causes physiological changes to the brain. They believe these changes to be permanent.

You still have not explained why this question is so important if your only symptom is head aches. What symptoms do you still need recovery from ?

Again Mark, thank you for your in depth feedback. And I appreciate your long term dedication to research on all things concussion. A couple things.

First, you are not my doctor, and I do not want you to treat me as a patient asking a question. I never asked about *my* concussion and *my* situation in particular, but I specifically asked for feedback on the ****general question**** of whether concussions can heal 100% or not. I am not concerned with what your opinion is on my **particular** situation Mark. I was looking for feedback on a general question and it is my business how I apply that to my situation. I do not know how I could be more clear here.

Second, I understand, and I am willing to accept the *possibility* of there being lasting damage 100% of time that will never heal. That is based on the information you have provided. But, for you to say that, since I do not 100% accept what you have given as fact, and that therefore means i have "rigidity of thought" and "trouble with my logic processing" sounds a little like you believe yourself to be the all knowing oracle of everything concussions and is a bit of a turn off. Maybe your severe concussions have created this? Yes, so far the studies you have mentioned do show that lasting damage is a reality. But to say that those studies have proven that ALL concussions 100% of the time, measured along every length of time, among the full range of human circumstance, will 100% unequivocally show that lasting damage is 100% fact ALWAYS the reality, I highly doubt that the range of participants and circumstance would allow for this kind of conclusion. And I also understand it is not realistic to have this complete of a study pool and that studies do their best to be as broad as possible. ALL I'm saying Mark is that my mind is still open to the possibility of 100% recovery. I'm also open to the fact that I could be wrong, and your research definitely lends to this. At this point, what would make most sense, is for to me do some of my own research, confirm with other sources, and then come back and continue the discussion. But obviously, this would take much time. Since you are giving the example of Doctor talking to patient, how is wanting to get a 2nd opinion and doing some self research before making a conclusion "rigidity of thought"?

In terms of my symptoms, well I still am getting occasional headaches, and I seem to have a bit of haziness, just not feeling 100% But this really could be from the headaches as well as a possible placebo effect from my mind obsessing over the fact I had a concussion and making something out of nothing. At the end of the day, as I said, it's more the unsettling idea that the brain can't heal 100% that bothers me, versus the actual symptoms. I do expect the symptoms to go away eventually.

And I do agree with you on the nicotine thing. I have stopped cold turkey as I want to play it safe.

**p.s. I forgot to ask, could you link me to some of these studies you have mentioned regarding the brain never fully healing? I would be very interested to read them. Thanks.

Just a reminder that it is a fine line between members discussing and not agreeing with each other versus becoming personal and negative in that disagreement.

Sometimes it may be best to just agree to disagree and move on.

Please avoid the personal negative comments if this thread is to remain open.
thanks

John,

I have only two points.

First, You refuse to accept that my comment of "In my PERSPECTIVE, it APPEARS" as what is says. I describe rigidity of thought for your information, not as an accusation.

Second, Rehabilitation specialists have found that accepting the current state of recovery as real is a starting point toward maximizing recovery. This is important because anxiety is the worst thing for recovery. The toxic brain chemistry caused by anxiety is counter to recovery. Plus, the lack of quiet rest where the brain relaxes and lets go of stressful thought allows the brain to apply its resources to recovery.

And, Yes, you are right. The research is not complete enough nor long enough to prove that over a lifespan, 100% recovery is not possible. It has looked at 10 and 20 year spans between known injuries and continuing evidence of the prior injury. But, as you say, it does not cover all persons so some may have recovered 100% without ever being examined. Unfortunately, the research to prove that 100% recovery is impossible. There are just too many variables to make such a study scientific.

Google "long term effect of concussions" and you will find lots of information. Most is related to those symptoms that are still noticeable. Some relate to dysfunctions that show even though there are no noticeable symptoms. You need to find the studies that have a broader cohort to find the most applicable information. You also need to find the studies where they found these abnormalities in what was thought to be a control (no concussion group) but in hind sight, the individual subject could point to a time where he may have suffered a concussion even though it was not a diagnosed concussion. I have hundreds of links to information.

Dorothy Gronwall did much of the pioneering research in the 1970's. Her work is not available online since her books are still being sold in print only. She died in 2001 due to a brain aneurism. You might find some excerpts online.

There is a phrase used by those in the know. "When you have seen one brain injury, you have seen ONE brain injury." There is strong evidence that shows one can not compare concussions. A 'mild' concussion in one subject may heal to no recognizable symptoms quite quickly and another even milder concussion can manifest symptoms for a prolonged period of time. This does support your claim that 100% recovery can not be excluded.

So, shoot for the moon. Maybe you will be one of those who has escaped detection and recovered 100%. Please keep in mind that anxiety is a big factor in slowing recovery so trying to live a low stress and anxiety free life is important.

My best to you.

Mark,

I understand that of course those were your perspectives, what else could they be. But they are your perspectives on an aspect I specifically asked not to be talked about. To just keep it to the general question of concussions was my request. That is all.

I will take your advice on googling "long term effect of concussions" as I am curious to do further research.

Aside from everything else, thanks very much for your knowledgeable feedback thus far, I do appreciate it. It has opened my mind to other areas of long term concussion effects I knew nothing about.

And thank you for your advice on the supplements and your further insight into the effects of nicotine. I also agree very much with your comments on anxiety and healing. Keeping an anxiety free environment is definitely paramount for optimal healing.

Best to you as well sir.

Hmm, I guess it depends on what you mean by 100% recovery, if you mean will I be able to run, swim, read a book etc etc again then I would say yes you will. The brain has a fantastic capacity for recovery but it takes time and nurturing. You also have to factor in severity of impact, age and general health but even so the outcome is positive.

However, I've found it's not a linear road, I went through months of very little progress which was depressing followed by a week of real improvement. I'm still working out why this is so.

does anyone know why there is such stepwise improvement seemingly in all tbi cases? either spontaneous within the first week(s) or month(s). if it is regeneration of tissue.. that doesn't really make sense does it?

There is some evidence that the brain has a system that tries to recover from injury but after a while, it may recognize that certain parts of the brain are not able to recover. At this point, it sends out die signals those cells die and are absorbed. Now, the brain has to learn to work around these broken areas, if it is possible. My neuro stated this in a 'recovery reserve' way. For some, this recovery reserve can take over. For others, this recovery reserve has already been used up. This would fit with the Multiple Concussion Syndrome process when after a number of concussions, recovery is haphazard and prolonged with some symptoms remaining.

The other issue to consider is that some concussions are just in the brain. others include upper neck injuries that impact how the brain recovers. Until those upper neck injuries are treated and healed, the brain continues to struggle.

There is what is called a brain stem concussion. This can have some difficult symptoms with some dysfunctions that last.