Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 10-21-2018, 08:41 AM #1
Carrico Carrico is offline
Member - formerly TT1234
 
Join Date: Sep 2013
Posts: 49
10 yr Member
Carrico Carrico is offline
Member - formerly TT1234
 
Join Date: Sep 2013
Posts: 49
10 yr Member
Default A Long-overdue Introduction, and a Wild Speculation

Hello everyone,

I'm a 21-year-old fellow who's been reading this forum on and off for the past five years or so. I've only ever made a handful of fragmentary posts, so I thought a longer one might be in order. I also want to bring up a theory that I've seen briefly mentioned but never really taken seriously in the forum (perhaps with good reason).

I don't want to go into exhaustive detail about my medical history. Suffice it to say that, unlike most people on the forum it seems, I never suffered a serious concussion. I had a minor concussion at age 10 caused by pitched baseball. I never lost consciousness but was quite sick and disoriented in the hours after the pitch. CT scan in the emergency room was clean. I don't recall any lingering symptoms beyond a day or two after the injury.

At age 12 I accidentally banged heads with another student in gym class. We ran into each other at full tilt. Again, as far as I remember, I felt perfectly normal after the injury.

In the weeks after the second injury, however, I started developing various symptoms of PCS, not all of which I'll list here. I never fully rested myself physically or mentally for quite a while after that injury. In the following years I banged my head many more times in the usual ways (car doors, bunk beds, etc.) but never in ways that I would expect to cause problems for a healthy person.


I am now much better than I once was. My only real remaining complaint is the one that crops up again and again on this forum: sensitivity to bumps. The story is old hat here by now, but I'll just go over it one more time: jostles, jolts, minor bumps, car rides, and such like give me a headache and foggy thinking for days afterwards. Usually four days at most, but sometimes a few weeks. As I've mentioned in a previous post, by far the worst jolts are those that come from my own feet. If I miss my footing and come down hard on my heel, I will usually be out of commission for days, sometimes a week or two. I am entirely convinced that there are both psychological and non-psychological components to these relapses.

I have managed to considerably lessen this problem with memory-foam shoe inserts. But it is still a problem.

Now for the theory. I've seen the idea mentioned on this forum a couple times before, though never with much serious discussion, that many lingering PCS symptoms might be due to cerebrospinal fluid (CSF) leaks. In particular, there are some old posts suggesting that head sensitivity might arise from inflammation caused by a CSF leak, or from a lack of CSF to cushion the brain from impacts. It seems like a long shot, but it also seems possible. (There is much interesting literature on CSF leaks to be found on the internet. I saw one study, for instance, that looked at sufferers of whiplash injuries with ongoing headaches and neck pain; more than half of them turned out to have leaks.)

I have gone perhaps further than most in following up this possibility: I have had two blind epidural blood patches and an MRI of my entire spine. The MRI was dubbed "clean," although it did show brain descent of one or two centimeters, which I understand is vaguely indicative of leak, though nowhere close to conclusive. The patches did not really help me, although they certainly made me feel different for a while afterwards. I will gladly go into more detail about them in a subsequent post.

What I want to ask now is whether anyone else has given much thought to this theory, has seen any illuminating studies, had any personal experiences with leaks, or just generally has any thoughts about the theory.

Best wishes,
Carrico
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Old 11-24-2018, 05:24 PM #2
swampmonster14 swampmonster14 is offline
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swampmonster14 swampmonster14 is offline
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Default Interesting

Sorry about your struggle, I have a similar issue of head sensitivity after a bad whiplash/head injury that has been persistent for 2 years now, main problems being exercise intolerance, trauma Induced gastroparesis, and extreme head sensitivity. Your theory is very intriguing, I will do more research on the topic. Any treatment ideas geared towards this theory?
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Old 11-25-2018, 11:20 PM #3
Beelzebore92 Beelzebore92 is offline
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Join Date: Jun 2015
Location: New York
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Beelzebore92 Beelzebore92 is offline
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Default

Hi Carrico. Can you message me the literature on this topic?
I've suffered multiple concussions, recovery just passed the 4 year mark. My signature is out of date so apologies for that.
Since my injury I've gone back to school to study the mind and the brain.

I don't know what it takes to identify or rule out a CSF leak, or what exact symptoms these could cause. It's an interesting subject. I really have very little idea about the mechanisms of the CSF environment in the brain - a neurologist would be the person to write to. I could also consult an expert tomorrow when I have a chance. I wonder what a blind epidural is or does - I didn't take the chance to research before writing this response.

Considering the question though, sensitivity to jostling and head bumps is pretty general and could have a number of different causes that vary person to person. I think changes to stability in the neck is another plausible explanation. The head is heavy and the neck is largely soft tissue that can be injured along with a head injury. Reduced neck stability could make it more susceptible to future strains and sprains - and someone who has had tbi may tense up their neck even for minor bumps, verses someone who has never had tbi will be more relaxed. This may be a learned response to trauma. I know for myself, my reflexes when something - anything - comes near my head are still erratic, even 4 years later. Neck strain and tensing up can cause symptoms that overlap with tbi, such as dizziness and headache. Dizziness and headache make cognitive tasks more difficult. It could also be the reverse is true - not that people with concussion are more susceptible to neck strain, but that after concussion, the brain's performance will be more sensitive to changes in the body, such as slight injury to the neck.

As you mentioned, I also wouldn't rule out psychology and memory. Concussions and the subsequent symptoms are traumatic. I'm inclined to think that there is a memory component to concussion such that future jostling might activate memories that reactivate symptoms. This may be similar to the way that people who experience traumatic events can "relive trauma" with specific triggers.
But I would also expect more explanations regarding minor bumps to turn up as more research is done on the topic of concussion.
__________________
-First TBI in 2011. Iron cellar door closed on my head. Undiagnosed PCS, and was unaware of anything regarding TBI at the time.

-2nd TBI in August, 2014. Fell skateboarding and hit head on pavement.

-3rd TBI in November, 2014. Hit in the head at work with a dish rack with full strength by a large employee. CT scan normal. Diagnosed mTBI, PCS, PTSD, migraine with aura, and chronic depression. Symptoms have included: quite severe visual disorders, hearing loss in left ear, lethargy, brain fog, dizziness, disordered sleep, hallucinations and "exploding head syndrome", neck and shoulder pain, migraines, headaches, loss of emotions, all forms of cognitive deficiency, loss of reading/verbal ability, sound/light sensitivity, anxiety, panic attacks. Most notably are a general loss of identity and the disillusionment with the world accompanying trauma. But on the other hand, a new and heightened awareness of the nature of self, others, and of suffering itself.

-As of December, 2015, am still experiencing visual disturbances, memory and speech problems, balance, sensitivity and overstimulation issues, along with the trickier to pinpoint cognitive changes, but feel that I am no longer clawing my way through a waking hell, so feel much better about being alive. Hallucinations and panic attacks are gone (thank God!), getting much better at reading and writing, and remembering/planning my daily tasks. Hopeful for further recovery, but thankful to be at least at 50%.
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