If you are suffering from post concussion symptoms, please refer to this page where I share more about my wife’s brain injury and the doctors that made her recovery possible.

When you sustain a traumatic brain injury, the type, severity, and frequency of the trauma can determine the level of damage. Upon injury, you may experience three types of symptoms:

  • Neuro-biological – physical damage
  • Neuro-cognitive – cognitive difficulty
  • Neuro-psychiatric – mental difficulty

Physical Damage from Traumatic Brain Injuries

Traumatic brain injuries can cause physical damage to the brain. For example, they can damage the blood-brain barrier, deprive the brain of oxygen, and trigger a neurotoxic immune response.

Damage to the Blood-Brain Barrier

The blood-brain barrier can be weakened when the membranes underneath the skull that protect the brain tear. This can cause dangerously high levels of reactive oxygen species (ROS) to be released, which can lead to cell death. As the blood-brain barrier weakens, potassium, chloride, and sodium may leak into the brain, causing swelling and disrupting communication between brain cells. This can result in loss of consciousness.

Oxygen Deprivation

When the brain is deprived of oxygen, energy cannot be produced through the normal process. Instead, lactate builds up and can cause more cell death.

Neurotoxic Immune Response

After a brain injury, the brain’s immune response is triggered and microglia – the brain’s primary immune defense – activate to clean up dead cell debris and strengthen the blood-brain barrier. However, the release of glutamate in toxic amounts can lead to injury and death of neurons, a condition known as excitotoxicity. If another brain injury is sustained before the brain can heal, the damage can mount.

Secondary Brain Injury via Inflammation

Inflammation caused by a brain injury can lead to secondary brain injury. When the body sends extra fluid and nutrients to heal the injured area, the brain may swell with the extra fluids. This can cause parts of the brain that were not initially injured to become damaged under pressure. It’s important to see a doctor as soon as possible after sustaining a brain injury to prevent this from happening.

Cognitive Difficulty from Traumatic Brain Injuries

Physical damage from brain injuries can create a range of challenges for survivors, including difficulty with cognition. This is common after TBI, even with mild injuries, and the extent of the difficulty varies based on the location, type, and severity of the injury.

TBI survivors may find it difficult to understand abstract concepts like time or space, and this can make them feel less “human.” They may also experience difficulty with attention, working memory, executive functioning, information processing speed, and long-term memory.

Cognitive difficulties can result from the above mentioned neurobiological problems such as diffuse axonal injury, inflammation, and mitochondrial dysfunction. These cognitive difficulties may resolve or improve over time, but they may also persist and continue to affect daily life.

Neuro-psychiatric – Mental damage

Brain injury survivors commonly experience mental difficulties, including post-traumatic stress disorder (PTSD) and depression. Studies have shown that depression affects 20-60% of TBI survivors, and is associated with reduced levels of serotonin and disruptions in brain circuitry. Additionally, brain injury survivors are at an increased risk of developing an addiction, and are more likely to report binge drinking.

The most frequent neurologic symptoms associated with TBI include headaches, light and sound sensitivity, dizziness/nausea, fatigue/lethargy, and insomnia. Headaches can manifest as cluster, tension, and migraine types, and these symptoms may persist for any amount of time depending on the nature of the injury and soft tissue damage. It’s worth noting that neurological symptoms of TBI may not surface for months or years after the initial injury, and approximately 15% of brain-injured people will experience chronic symptoms lingering for months or even years in a condition known as Post-Concussive Syndrome.

What Should I Do If I Have A Concussion/TBI?

If you suspect you have a concussion or TBI, it’s crucial to seek medical attention as soon as possible. Depending on the severity of your injury, treatment options may include rest, medication, cognitive rehabilitation, and therapy. For more information on what to do if you think you have a concussion or traumatic brain injury, please refer to this page where I share more about my wife’s brain injury and the doctors that made her recovery possible.