Multiple areas of the brain are involved in TBI and concussion.
Concussion, or traumatic brain injury is common among contact sports participants. Concussion has been defined as a condition in which there is a traumatically induced alteration in mental status, with or without an associated loss of consciousness. In reviewing the scope of symptoms of actual concussion patients, further specificity can be discussed. Dizziness or vertigo is an erroneous perception of self motion or perception of environmental motion and of gravitational orientation. Most patients who have suffered a concussion experience this phenomena of symptomatology. Typically this perception is created through a mismatch between the vestibular, visual and proprioceptive, (sensation of the earth under your feet), systems. Because of the overlap of these systems, they each tend to compensate for deficiencies of the others by design. This is why when the lights suddenly go out, or you suddenly step onto a soft spongy surface such as wet sod from a hard surface such as concrete, the normal brain can quickly compensate by changing between these three systems to prevent falling. TBI does not produce a specific disease entity, rather, it causes a syndrome of mismatches of the stabilizing systems described above, in addition to headache and other symptoms. There is no evidence that medication improves recovery after concussion. Further, research has found that overuse of analgesics following injury may exacerbate concussion-related headaches or make them chronic. The most common treatment recommendations for concussion are rest. But this too has not met with satisfactory results as concussion symptoms commonly continue or worsen. An athlete who has a history of one or more concussions is at greater risk for being diagnosed with another concussion. The first ten days following a concussion appear to be the greatest risk for being diagnosed with another concussion. Second concussions are bad for several reasons. The brain has not yet recovered from the first concussion, so the damage becomes cumulative. Second impact syndromes are often the cause of fatalities in concussions, sports related, (adolescent and pro), or other causes. Although rest initially following a concussion is often advisable, it is not solely the best treatment for concussions. Our office uses the most contemporary and proactive treatment methods in the management of concussion brain injuries. We do this by directly affecting the aforementioned systems of balance for as long as these systems continue to be mismatched, there can be no recovery, and as long as these systems remain mismatched, they will perseverate the other concomitant symptoms associated with concussion and traumatic brain injury. More information on traumatic brain injury and treatment can be found on my website at www.dcneuro.net.
The main causes of concussions are typically anything that involves a head injury. This can include sports activities, and all too frequently, automobile accidents. Severe concussions, because of the immediate symptoms, are often followed up upon with medical care. It is however the less severe impacts that can become more problematic as these are not always brought to the attention of a medical person. In addition to neurologic symptoms which can develop following even a mild concussion, even more serious is something called second impact syndrome, whereby an individual with a concussion has a second one and has not yet recovered from the first. This can be so severe that it can actually be life threatening. For these reasons any suspect concussion, i.e. any head trauma, should be followed up for appropriate examination by a medical person well trained in post concussive injuries. The most common symptoms following a concussion include sensitivity to lights and sounds, and often altered sense of smell and difficulty reading. The latter is often inappropriately thought to be due to age related deterioration in vision, but is in fact due to an inability to properly place the eyes in the correct position and keep them there while viewing a target, or while moving the eyes from one target to another, or while following a target, as occurs with reading. My office is used to seeing patients who have had an untreated concussion years ago only to find worsening symptoms now. Naturally these are much easier to treat earlier on.
Things that you can do if you believe you may have had a concussion: The simplest thing you can do is come in to our office for a balance test. The test takes less than one minute to perform and yields an extraordinary amount of data relative to you postural systems and your brains ability to resist the earth’s gravitational pull properly, i.e. risk of fall. Our office does not charge for this service as we offer it as a free community service. Our office is additionally equipped with a complete balance center, including infrared video goggles which allow us to record and watch your eyes while following targets on a computer screen in real time. This information is essential to properly treat someone whose brain has been injured.
Various 2012 studies further clarified how excessively sweet, unhealthy foods affect the brain. An animal study out of UCLA found that diets high in fructose can impair cognitive function, which is reversible with omega-3 fatty acid supplementation. High fructose consumption can induce some signs of metabolic syndrome in the brain and can disrupt the signaling of the insulin receptors and reduce the action of insulin in the brain. Other work published in JAMA suggests that fructose consumption modulates the neurophysiologic pathways involved in appetite regulation and encourages overeating. An October 2012 study published in the Journal of Alzheimer’s Disease reported that a diet high in carbohydrates and sugar raises the risk for mild cognitive impairment in the elderly, while a diet high in fat and protein may reduce this risk. Logical yet simple enough, an “optimal balance” of carbohydrates, fat, and protein may help maintain neuronal integrity and optimal cognitive function, particularly in the elderly.
Mounting evidence in 2012 reinforces that high consumption of red meat increases stroke risk. The largest meta-analysis to date looking at the atherogenic effects of red meat found that the risk for total stroke increased by up to 13% for each increase in a single serving of fresh, processed, and total amount of red meat consumed per day. Earlier in the year another study found that processed and unprocessed red meat is associated with a higher risk for stroke, while poultry was associated with a reduced risk. One study found that a diet high in fruits, vegetables, grains, and fish led to a 30% lower depression risk compared with a meat based diet. But, as pointed out last year, meat quality is a factor: Moderate consumption of unprocessed, free-range antibiotic free red meat may actually protect against depression and anxiety. Much of the livestock in the United States is raised on industrial feedlots, which increases saturated fat and decreases very important good fatty acids, whereas pasture-raised animals have a much healthier fatty acid profile.
Information derived from Medscape.
A study conducted in Spain reported that consumption of both polyunsaturated fatty acids, (found in nuts, seeds, fish, and leafy green vegetables), and monounsaturated fatty acids, (found in olive oil, avocados, and nuts), decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk. Trans fats are found extensively in processed foods, including many commercial chocolates, (hence, check that label when considering dietary intake of chocolate. Also, only the highest levels of dark cocoa contain healthy antioxidants, not milk chocolate). A deficiency in polyunsaturated fatty acids has been linked to attention deficit/hyperactivity disorder in children. Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms, and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals. Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide. Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels. Keep in mind that Atlantic fish have elevated levels of mercury and PCB’s compared to Alaskan/Pacific fish, and that farm raised fish contain very little healthy omega 3 fatty acids, due to the confined breeding of farm raised fish.