Treating Traumatic Brain Injury

Brien Roche

Treatment Must Be Geared to Healing and Compensating

Treating traumatic brain injury has evolved over the years.  Most doctors now recognize that treatment must be closely integrated with emphasizing that the patient gets adequate sleep, good nutrition, good hydration and appropriate exercise.  Once the patient has been fully stabilized, then pharmacological treatment can be implemented.  All of this has to be done with the recognition that the biggest enemy to treatment may be the patient himself.

Aside from relying on the natural healing powers of the body, the methods of treatment are several. They may be pharmacological which includes methods of regenerating brain cells. They may be physical therapy which is designed to deal with physical pain and limitations. They may be occupational therapy designed to train the brain “how to get the job done”.

Some basics as to healing and treating:(a)Most brain injuries heal within a year. (b)Older people heal more slowly than younger people. (c)The brain may never heal but it still can compensate. (d) Also if the injury is permanent then the compensation may come in two forms: (i) Finding alternative ways to get the job done. (ii)Re-training the brain to perform the function.

Compensating for Brain Injury

If the brain injury has not healed within a year chances are it will not heal. It is quite common that people with brain injuries learn how to make up for what they have lost. However they can only do this in familiar settings. For example, at work they know the environment and through post-it notes and “cheat sheets” they may be able to perform their routine office tasks. The same may be true at home. However take that person outside of their comfort zone and they are confused and panic may reign. This can present a problem as far as proof and treatment. The injured person may have learned to adjust so well that fellow workers may not even be aware of the problems. In addition the injured person may understate how they feel. Call or contact us for a free consult.

If the compensation comes in the form of re-training, that takes prolonged repetition to create new muscle memory.

Variables in Treating Traumatic Brain Injury

1.  Variable Symptoms From Brain Injury Based On Gender

The January 2011 issue of the Journal of Athletic Training reports, based upon studies of a hundred different American high schools, that males and females show varied symptoms after head injuries.  The symptoms noted by males more often fall into the area dealing with feeling like they are in a fog, trouble focusing or memory issues. On the other hand females report more behavior and somatic symptoms such as sleeping more than usual, drowsiness, fatigue, nervousness, headaches, nausea, being sensitive to light and noise and balance problems. Any injury lawyer handling brain injury cases needs to be aware of this.

Sports trainers and doctors should be aware of these reports.  Many of the symptoms reported by females may be missed or more likely linked to problems other than a brain injury. Brain injuries by their very nature involve rather diffuse symptoms that doctors may not always relate to the injury.

2.  Variables Based on Type of Injury.

a.  Hypoxic Brain Injury

Hypoxic brain injury is from the brain being deprived of oxygen for a long time. This type of brain injury is from choking, trauma, drug overdose, smoke inhalation, carbon monoxide poisoning or near drowning. Brain cells need oxygen to survive. If they do not receive enough oxygen, then those brain cells may start to die within minutes.

Signs and symptoms of hypoxic brain injury:

• Short term memory loss
• Seizure
• Amnesia
• Poor judgment.
• Loss of coordination
• Inattentiveness

b.  Neurotoxic Brain Injury

This form of brain injury is caused by toxins such as lead, paint or other chemicals.  The brain and nervous system control all body functions.  Any insult or injury to the brain or the nervous system affects the entire body. There is no easy way to make the diagnosis of neurotoxic brain injury.  In addition many doctors are simply not aware of the symptoms of this type of injury. Call or contact us for a free consult.

Signs Of Injury

To determine whether or not a person has suffered such a brain injury there are several things to consider:

• The Material Safety Data Sheet (MSDS), required by law of every manufacturer, is a good starting point when seeking info about a chemical’s adverse effects.  The MSDS lists those effects.
• A common result of this type of brain injury is multiple chemical sensitivity.  That is, the client becomes sensitive to a number of other products as a result of  this event. People who suffer from multiple chemical sensitivity become very ill from the exposure to everyday chemicals such as perfumes,  paints or cleaning products.
• The body stores these toxins in fat and other tissues. They are longer lasting than if they existed  in the blood or urine.  Searching for some sign of the injury is like searching for a bullet that has fully passed through the human body.  The bullet is never found but that does not mean that the subject was not shot.

Safety May Be A Compromise

• The fact that the product complies with the standards for exposure does not mean that the product did not cause injury.  So called “safe” levels of exposure are sometimes a compromise between what the industry wants as to that product and what the consumer protection people will accept.  In addition, such safe levels are set to protect a healthy male worker.  Those who do not fit into that group are not covered.
• The fact the product may be inert does not mean that it is  harmless.  The portion of the product that is not inert may be what is toxic and active.
• Simply smelling the product may cause injury.  Breathing in or having skin contact allows the substance to enter into the blood stream without any filter.  For instance, doctors now use skin patches to administer morphine and even birth control.

Modes of Treating Traumatic Brain Injury

a.  New Mode of Treatment

First, a clear diagnosis must be made as to what part of the brain or vestibular system is injured. Then treatment is tailored to that injury.

The vestibular system is a network involving organs in the inner ear with paths to various areas of the brain, the eyes and muscles throughout the body.  In regards to brain injury treatment, doctors have focused on vestibulo-spinal system treatment.  That is the system that helps control posture and maintain balance.

Some concussions affect the vestibular-ocular system which allows stable vision while moving our heads. Injury to this system causes dizziness, nausea and other symptoms.  Also the injury may be to the vision system.  The vision system is what allows us to track moving objects without effort.  Injury to this part of the brain can cause blurred vision, headache, trouble reading or walking in a crowded area.

Many brain injuries involve all of these systems.  As such treatment may need to address both balance and vision.

b.  Traumatic Brain Injury Treatment: Mount Vernon Hospital and Fairfax Hospital

Mount Vernon Hospital and Fairfax Hospital have concussion centers that provide brain injury treatment which follows the philosophy that sometimes the brain has to be taxed a bit to heal and adapt.

The testing of someone who has suffered a head injury must assess their balance in many positions i.e., standing on two legs, standing on one leg, on the ground and then on a foam board and then with eyes open and eyes closed.  Eye movement and being able to track a moving object are also measured to see whether symptoms worsen with any of these tasks.

Focus On The Injury

Concussions are brain injuries that damage cells. Also they can cause chemical changes. They disrupt the brain’s normal function in a number of ways.  Although rest, staying in a dark room, turning off screens, limiting movement and cutting out things that require focus have been the mainstay of treatment that theory is changing. Although rest is still critical in the first days after an injury, if there is not a prompt recovery then there is a need for more active treatment. That treatment must pinpoint the problem and prescribe targeted therapy.

There are some studies that show good results from exercise or vestibular treatments.  Just as every stroke patient is not treated the same way, brain injury treatment does not follow a cookie cutter approach.  If the patient has a language problem, trouble with their eyes, trouble with their gait, then those things need to be measured and those problems need to be treated. Call or contact us for a free consult.

Focus on the Person

The Center for Disease Control estimates that 2.5 million people in the U.S. suffer a traumatic brain injury every year.  That of course doesn’t include the many people who don’t even report these types of injury.

The idea of exercise therapy in terms of treatment is accepted.   Monitored exercise promotes recovery.   Concussions affect the flow of blood to the brain and thereby disrupt what is called the autonomic nervous system. This controls such functions as heart rate and blood pressure.  Controlled exercises may help correct these.

Headaches are a frequent symptom of traumatic brain injury.  The headache may be due to injury to the vision system. Such headaches may respond to vision therapy.  Neck injury may be the cause of headaches.  Medication or therapy may help with those neck injury symptoms.

c.  Treating Football Players

An article of June 8, 2012 in The Washington Post  recounts some comments of Daniel Amen, a California doctor, who noted that he has had success with football players and others who have suffered many concussions. He has improved their decision making, mood and memory and also helped them deal with depression.

Amen himself has worked with 117 former NFL players and says that 8 out of 10 of his patients have great improvement.  Nick Bell, a former running back with the Raiders, is one of Amen’s patients.  Bell reports that he had many concussions and that after one he actually wound up going into the other team’s huddle for the next play.  He says that back then if you complained to the coach, you were benched and may not see any further action.

Amen’s Treatment

The routine that Dr. Amen has put Bell on involves supplements, hyperbaric oxygen treatment, fish oil and exercise.  The goal is to try to grow brain cells and boost the neuron connections. All of this may improve brain function.  Dr. Amen reports that in Bell’s case there has been a 30% improvement in terms of memory, attention span and processing speed.

Another common effect of these injuries is sleep apnea. This can cause a person to stop breathing while sleeping, high blood pressure and a tendency to gain weight.

All of these problems can be dealt with through proper treatment as seen in the treatment by Dr. Amen.

Also see other pages within this site on tbi and seeing it. See the pages on Wikipedia