Have you hit your head?

So you’ve hit your head, or sustained a whip lash injury that has caused trauma to the brain (mTBI or concussion). You don’t have to sustain direct impact to the head or lose consciousness to be concussed. What physiological changes happen in the brain to explain such a wide array of symptoms? Well, based on the acceleration or torque forces, axonal fibers in the brain are torn. An axon is a projection of a neuron (nerve cell) that conducts electrical impulses of our nervous system. Research shows the axons do not break but the microtubules (or messenger structures) within the axons do. If this messenger system is disrupted, chemicals build up, and the ability to transfer electrical impulses, is lost. Everything the brain does is based on the firing of theses neurons, so no wonder there are behavioural and personality changes with mTBI.

The chemical build up results in a neurochemical cascade, which disrupts cellular sodium and calcium levels, destabilizing cell membranes, causing an increase in glucose consumption, decreased energy storage, which can lead to cell death. The brain relies on glucose for energy, does not store it, and is therefore, VERY sensitive to changes in cellular metabolism. None of these changes are visible on MRI or CT scans and there are no direct pharmaceutical interventions available. Hence, complementary medicine!  Neuronal damage. Metabolic changes. Energy demands. Due to the complexity of the brain, depending where the damage is, affects the symptoms that ensue. For example: frontal lobe, temporal lobe, occipital lobe, parietal lobe injuries all differ based on function and cognitive role.

 https://www.brainfacts.org/brain-anatomy-and-function/cells-and-circuits

https://www.dana.org/article/how-does-the-brain-work/

What is a concussion?

·      Bump, blow or jolt to the head that causes brain malfunction. Not all hits to the head are TBIs (traumatic brain injury) and not all TBIs require you to hit your head. Mild TBIs are the most common form of brain injury are are commonly referred to as concussions, or mTBI.

·      Of all injuries worldwide, brain injuries are most likely to lead to death or permanent disability. 452 people per day suffer serious brain injury in Canada. 44 times more common than spinal cord injury and 30 times more common than breast cancer.

·      1/3 Canadians are directly impact by a brain injury in some way.

·      Estimates put First Nation peoples 4-5 times more likely to experience a brain injury than the general population.

https://www.nbia.ca/brain-injury-statistics/#:~:text=Brain%20Injury%20occurs%20at%20a%20rate%20of%20500%20out%20of,injuries%2C%20or%20unreported%20cases).

Random concussion facts

•  Did you know women may be more susceptible to concussions than males, due to the size of neuronal axons?

  (https://ndnr.com/naturopathic-news/women-may-be-at-greater-risk-for-concussions/) Dollé JP, Jaye A, Anderson SA, Ahmadzadeh H, Shenoy VB, Smith DH. Newfound sex differences in axonal structure underlie differential outcomes from in vitro traumatic axonal injury. Exp Neurol. 2017;300:121-134.

•   The axons do not break but the microtubules do, causing major molecular imbalances of neurons – if the transport system is broken, chemical messengers can build up causing electrolyte imbalances.

• The ability to transfer electricity is lost! Hence behavioural and personality changes.

ReD flags

You or a friend has hit their head. Someone always asks, "should I go to the hospital?"  There are certain RED FLAG symptoms that if you observe them or experience them, please go to the ER immediately! If you are unsure, best to get checked out.

 •               One pupil larger than the other, double vision

•               Severe or increasing headache

•               Neck pain or tenderness

•               Nausea / vomiting, convulsions, or seizures

•               Loss of consciousness

•               Inability to wake or extremely drowsy 

•               Slurred speech, weakness, numbness or decreased coordination

•               Lack of memory (day, time, events leading up to accident) 

•               Unusual behaviour, increased confusion, restlessness, or agitation

•               For an infant / toddler: the above + inability to console, will not stop crying, will not nurse or eat. 

 Getting a proper exam from a trained professional, even if you don't experience these symptoms, is highly recommended! 

 Other common symptoms:

 We are pretty well-versed about the common concussion symptoms: headaches, sensitivity to noise and light, difficulty concentrating, memory loss, and balance and coordination issues to name a few. None of the above are fun and do greatly impact ones quality of life - work, play, and daily functioning. There are OTHER  symptoms of concussions that are less understood, less recognizable, and very important to acknowledge! An estimated 25% of mTBI patients develop a mental health condition such as depression or PTSD within 3 months of their injury. If these symptoms were more recognizable and understood, maybe we could prevent this?

The mental, emotional, behavioural changes:

•               Irritability, aggression, fear

•               Depression, anxiety, panic attacks

•               Disturbed sleep, constant fatigue

•               Changes in libido

•               Changes in appetite

•               Lack of energy and motivation

•               Sudden emotional outbursts and mood swings

•               Challenges with problem solving, decision making, organizing tasks

 It is very hard to observe these behaviours in yourself or in a loved one. It is also very hard to understand they are coming from a damaged brain, in the same way pain and loss of function comes from a damaged joint. You can’t see it and therefore, it seems to be the “person” not the injury. We identify with our thoughts and emotions. It’s how we interact with the world. Changes in that interface can be devastating and terrifying. The more we know, the more we can understand, empathize, and heal. We are experiencing a mental health epidemic. What if concussion awareness and concussion management could be a part of the solution? Please reach out if you need support or have questions for yourself or loved ones!