What Happens to the Injured Brain?
- Primary and Secondary Outcomes
- The ‘Secondary Injury’
- Prescribed Medication
- The Brain Environment
- Are Prescribed Medications Adding to your Bio-toxic Load?
- Addressing the Secondary Injury
- Addressing Symptoms
When brain injury happens, doctors usually explain that the brain has suffered events such as shearing, tearing and bruising.
Doctors rarely explain the science or deeper meaning behind medical events or alert people to the dangers of inflammation. There is, however, a lot of research into brain injury and the effects this has on the brain and person affected. What most people want to know, often more than anything else, is, is there anything I can do to help myself?
For those who are dismissed by doctors, or don’t have access to specialist care, understanding the science is a part of the information needed to be able to work on fixing the damage.
One of the most important things you can do post brain injury is to address the secondary injury.
Primary and secondary outcomes
Brain injury creates both primary and secondary effects.
Primary brain injury describes the incidence damage that occurs at the moment of trauma when the tissues and blood vessels are stretched, compressed, and torn. The secondary injury consists of the effects of the inflammatory response.
In other words, the initial mechanical or physical force is followed by a secondary injury which develops as the result of a biochemical cascade that occurs in the hours and days afterwards. The secondary damage is largely responsible for the ensuing symptoms and mental impairments.
Once flicked to the ‘on’ position, the switch will stay in this position until addressed. This response is the basis of post-concussion syndrome (PCS) and causes the prolongment of symptoms. This debilitating outcome is why we consider it so essential to increase awareness and to help people learn how to combat inflammatory responses.
Secondary events (inflammatory responses) include:
- Damage/disruption to the blood-brain barrier
- Necrosis – cell death caused by an external force
- Apoptosis – cell death due to biochemical signals
- Excitotoxicity – the excessive release of the neurotransmitter glutamate
- Dysfunction of mitochondria
- Oxidative Stress
The ‘secondary injury’
As a result of secondary injury, some injured axons in the brain matter may separate from their cell bodies, potentially killing those neurons. ‘Plasticity‘ and our ability to rewire the brain are crucial when it comes to hope, and also to understanding that there is a lot that can be done, in time, to recover or rebuild skills and a sense of self.
These ‘secondary events’ have a knock-on effect on the brain, and indeed the body. The inflammatory response can continue unabated until addressed, and so it is vital to be aware of this as early on as possible. The sooner we manage these events, the better. However, attending to the ‘on switch,‘ can be done at any time post-injury.
The cascade of secondary biochemical changes develops insidiously in the hours, days and weeks following primary trauma. Changes can progress gradually or subtly and can have very harmful effects.
Gary .L Wenk, Ph.D., describes secondary outcomes as a “progressive degeneration within vulnerable brain regions.”
He says that “Many of these changes are also commonly seen associated with advanced normal aging and are thus rather well studied.
One of the initial changes involves a dysfunction of the mitochondria inside of the neurons of the brain. Mitochondrial are responsible for energy production and are critical to the survival of neurons, which use a lot of energy.
The injury to the mitochondria leads to a condition called oxidative stress where individual atoms of oxygen that we inhale become very toxic to the brain.
Next, the oxidative stress induces brain inflammation which leads to an assortment of degenerative diseases, particularly during the years following the TBI event.
These three critical events following the TBI, i.e. loss of normal energy production, oxidative stress and long term brain inflammation, underlies the development of seizures, sleep disruption, fatigue, depression, impulsivity, irritability and cognitive decline.
Although no effective treatments are available to alleviate these biochemical events in the brain, research has advanced sufficiently to understand how specific chemicals in the diet can target the adverse effects of oxidative stress and inflammation.”
There is a lot of research emerging about these secondary events and scientists are also working on the development of drugs that could decrease the harmful effects of the inflammatory response if given in the acute phase.
For many, these new approaches have come too late. If this is the case for you, tackling the ‘three critical events,’ as described by Gary L. Wenk (See ‘secondary injury above), is crucial. While there is no medical protocol, there is enough scientific research to bring all the dots together.
If you are currently taking prescription medications it can be worthwhile to consult with your doctor to ask about using ‘natural’ remedies rather than ‘chemical’ ones; especially given that the injured brain can be susceptible to sensitivity to drugs. Try to find a doctor who has experience in treating brain-injured patients or ask for a referral to a neuropsychologist who will be able to guide your treatment.
Even though brain injury is not a mental illness, many doctors continue to treat symptoms individually with drugs designed for psychiatric use. That the underlying causes are different often means that drugs are ineffective or worsen symptoms and cause side-effects. Finding an experienced or functional doctor will help you to avoid some pitfalls.
Never stop any treatment plan without the knowledge and support of the prescribing physician.
Current medical protocols often don’t use the latest science and new findings can take ten or so years to filter into clinical practice.
The brain environment
Called epigenetics, we now understand that the genetic code, our DNA, – modifies with our environment. This ‘environment’ can even be changed by what we believe and what we feel. Epigenetics means “above” or “on top of” genetics and refers to external modifications to DNA that turn genes “on” or “off.” These modifications do not change the DNA sequence, but instead, they affect how cells “read” genes.
The health of the brain environment is crucial in recovery. Post brain injury the brain and the whole body are in a state of toxic overload. When we add more toxicity, including in the form of prescribed medications, we are inadvertently trying to treat symptoms by adding more to an already overloaded system. Some people are better able to cope with medicines than others. Sometimes sensitivity becomes more apparent over time. Always talk to your doctor about your preferences and review prescriptions and treatment plans regularly.
If we pause and think about it, symptoms are messages being given to us by the body that something is out of balance. If we listen to these messages, rather than trying to make them go away, we stand a better chance of bringing the body back into balance. When the body is back in balance, we sleep better, allowing for restorative and healing processes to take place.
It can take eight to ten years for new research to get into mainstream understanding, and in the meantime, people continue to live with the onslaught of biochemical reactivity. A functional doctor will have more empathy with any concerns and will have a whole-body approach that is important following any type of trauma affecting the brain because the brain regulates the rest of the body and vice versa.
Are prescribed medications adding to your bio-toxic load?
It is essential to be aware that some prescribed medicines are life-saving. Never stop or change any prescriptive protocol without speaking to the prescribing physician.
However, if you are taking medications to alleviate symptoms, you should maybe think about what you and your doctor are doing if you are concerned about adding to the bio-toxic overload. Let your doctor know that you would like to discuss alternative treatments.
Many people are treated under mental health protocols instead of being referred to specialist neurological services, sometimes resulting in a loss of self-esteem and opportunity to understand the condition.
You do have a ‘say’ in this. It is imperative to understand that the ultimate responsibility for what happens to your body, your capacity to ‘heal,’ actually lies with you. Your doctor(s) can only do so much and although there is a lot we can do to help ourselves, always talk to them first and never self-prescribe treatment plans for yourself without their help.
Addressing the secondary injury
By focusing our attention on the biochemical cascade, we can get the ‘on switch’ to turn back off. With the right guidance and help we can halt prolonged inflammatory responses and can work on reversing the adverse effects.
The following points are made by Matthew V. Russo and Dorian B. McGavern in their paper ‘Inflammatory neuroprotection following traumatic brain injury:’
- Some components of the neuroinflammatory response seem to play a beneficial role in the acute phase of TBI.
- Early inflammation can set the stage for proper tissue regeneration and recovery
- This can, perhaps, explain why general immunosuppression in TBI patients is disadvantageous
More research is needed into the role of inflammation at the acute stage, however, long-term inflammatory response contributes to fatigue and adrenal exhaustion.
The outcome of these efforts is a clearer mind and a reduction in symptoms allowing us to turn our attention to dysfunction caused by physical damage to the brain.
We can do this in a variety of ways: –
- Address and consider our beliefs
- Address our thinking about nutrition
- Learn more about how the ‘gut-brain‘ affects our brain, mental health and our thinking
- Learn about the natural substances that reduce inflammation and biochemical toxicity
- Understand the impact of synthesised chemicals on our bodies
 Science Mag
Many of the symptoms of brain injury, such as anxiety, brain fog, fatigue, depression, and headaches, are often caused by the biochemical cascade that happens immediately after any trauma to the brain. If we can reduce on-going inflammation, oxidative stress, and so on – we can also reduce these symptoms.
We need to be aware of doing this at the right time and the only way to understand when this is, will be with the help of your doctor or specialist.
When we address the causes of the symptoms, i.e. the biochemical cascade, we can reduce their impact and with an improved brain environment we have more clarity and increased ability to notice cognitive and executive impairments.
A clearer brain environment makes it easier for us to focus on the outcomes of the primary brain injury.
If you missed it, please see the information about ‘secondary injury’ on the A New Concussion/Brain Injury page.