Understanding and treating traumatic brain injuries
‘Traumatic brain injury’ are three words most of us don’t want to hear – not about ourselves or our loved ones. But life – and death – happens. Some injuries are fatal, and others can be operated on, leading to a full recovery. Some heal independently, and others cause symptoms that linger for weeks, months, even years following the incident.
Traumatic brain injuries are as diverse as the individuals they affect. In this article, we’ll break down these misunderstood ailments and shed light on the possibilities of long-term health and happiness.
Traumatic brain injuries are not created equally
You might know someone that has suffered from a traumatic brain injury. Perhaps you yourself were involved in an accident or nasty fall.
Sometimes, brain injuries are easily detectable. For example, if a vein or artery breaks, the damage forms a blood clot that presses into the brain.
Blood clots are often the result of a compression fracture of the skull. Sometimes, they are rapidly fatal. Other times, they are neurosurgical emergencies in which the patient’s life depends on evacuating the clot as soon as possible.
It’s not all that comfortable to think about, but, caught between the hard skull and soft brain, a blood clot has nowhere to go as it expands and grows. Something’s got to give, and that something is, of course, the brain. When vital structures are compressed in a particular way, essential functions like breathing and consciousness can shut down.
In some cases, the blood clot is small and, resulting in minimal neurological impairment, does not warrant the risks associated with surgery. The clot dissolves over time, allowing the individual to recover fully.
Other types of identifiable traumatic brain injuries include brain bruising, called a contusion, and bleeding into a subarachnoid space, called a traumatic subarachnoid hemorrhage.
These represent one group of traumatic brain injuries: obvious injuries that affect the brain’s structure. Another, less obvious group impacts the brain’s function.
The subtlety of functional brain injuries
Let’s say you were involved in a car accident. You were rear-ended, or you were nudged into someone in front of you. You experienced a sudden jerk – a deceleration. You were evaluated at the scene of the accident, transported to the emergency room, and had your vital signs checked. You also underwent a CAT scan or CT scan of your head.
The good news: no apparent signs of damage to the brain were identified. Your doctor tells you that you likely suffered a concussion. You felt a little dazed, a little confused, but these side effects slowly subsided – mostly.
Then, you’re sent home. Your doctor advised that someone, a loved one, should watch out for you and help you monitor your symptoms for the next 24 to 48 hours, just in case. You return to the hospital again a few days later for a final check, and your CAT scan shows a healthy, happy brain.
The bad news: you are still experiencing alarming symptoms – severe headaches, nausea, difficulty sleeping, dizziness, emotional agitation, and challenges with memory.
A month goes by, and then another, and the symptoms persist. Your brain scans continue to show a structurally normal brain, but you live with what’s known as chronic post-concussion syndrome.
Perhaps this situation is familiar to you, or maybe it’s just hypothetical. Either way, I know first-hand that this is a very real, very scary reality for many. I’ve worked with individuals that have been from doctor to doctor seeking answers, searching for a diagnosis that makes sense.
What is wrong with my brain? How do I resolve my symptoms? How can my brain be ‘normal’ when I experience concussion symptoms one, two, six months after the accident?
The answer lies in differentiating the structural from the functional.
Structural vs. functional traumatic brain injuries
Put simply, a structural change to the brain is something you can see – it sticks out like a sore thumb in a CAT scan or MRI of the brain. Even someone without a trained eye can spot most structural brain injuries.
Functional traumatic brain injuries affect how the brain works. They are invisible in typical brain scans like CATs, CTs, and MRIs.
The words function and physiology are often used synonymously, but that’s not always correct. Think about a car engine. When I talk about functional brain injuries, I’m not talking about the engine’s condition. I’m looking at what happens when the wrong fuel is used to power the engine. Functional changes are not big-picture – they’re granular.
Identifying functional traumatic brain injuries
The first step in my five-pillar approach to patient treatment is identify. If we don’t know the problem, we cannot develop an effective solution.
Here are a few ways I test for changes in the brain’s function resulting from injury:
- PET (positron emission tomography) scans that evaluate the brain’s metabolism. These generally measure how the brain utilizes glucose, its primary fuel source.
- SPECT (single-photon emission, computerized tomography) scans that examine the brain’s blood flow. These use some radioactivity.
- Computerized EEGs (electroencephalogram) that analyze the frequency or amount, distribution, and location of different brain waves.
- eVox tests from Evoke Neuroscience based out of New York City. This test, which I frequently use in my office, combines several examinations for a holistic picture that enables my team and me to identify patterns consistent with traumatic brain injury.
While the above examinations help identify and diagnose functional injuries, they are not always available to those living with chronic symptoms.
I’ve seen people genuinely suffering, not just from their condition but also from the frustration that comes from practitioners being unable to pinpoint the underlying cause of their struggles accurately.
And that is where I do things differently.
Accurate diagnosis is the first step in your journey to health and vitality
Every effect has a root cause, and I am on a mission to help people uncover the injury or imbalance behind their suffering. A diagnosis is crucial to unlocking a path to health and happiness, but it is only the first step. What follows is a comprehensive, multi-faceted treatment plan.
If you are sick and tired of doctors telling you that there is nothing they can do to improve your symptoms, please schedule a free consultation today. There is an answer – let’s find it.