The most common symptoms are as follows:
Sleep disturbed or excessive
Coordination and balance issues
Poor concentration and inattention
Memory impairment/ feeling like in a fog/confusion
Slower thought processing speed and/or delayed reaction time
Impairment of mental performance, organization ability and decision making
Depression/anxiety/irritability/easly frustrated/agitation/poor stress tolerance
PTSD may occur as well as seizures in more severe cases
It is my opinion based on all the available research that there is always some degree of brain damage in all TBI cases, even if the patient appears “OK”.
What is actually happening in the brain during this prolonged secondary component of TBI? There is damage to the actual nerve cells, particularly the membrane of the cells. A damaged membrane causes the mineral ions of calcium, sodium and potassium to become imbalanced inside and outside the cells causing the cells to swell leading to brain dysfunction and even more nerve cell death. Since 40% of the energy the brain uses is to maintain the balance of these mineral ions a major energy crisis begins as the brain struggles to maintain balance.
The brain also starts having trouble using glucose or blood sugar as an energy source causing an even greater energy crisis. Other than the building energy crisis, the four major problems in the brain are: Excitotoxicity, Oxidative stress, Mitochondrial dysfunction and Inflammation
Excitotoxicity: Caused by high amounts of a brain toxic chemical called glutamate being released from damaged brain cells. This further damages the cell covering or membrane, the mitochondria or energy generator in the cell and the cell’s DNA.
Oxidative stress: Also called free radical damage is what I call internal rusting. It is a similar process to what causes metal to rust. Free radicals are destructive compounds that damages cell proteins, enzymes, DNA and cell membranes even more. Free radicals can be thought of as the opposite of anti-oxidants.
Mitochondrial dysfunction: Mitochondria are the energy producing parts of the cells that are damaged by the above processes leading to even more of an energy crisis in the brain because now the mitochondria’s ability to use blood sugar is disrupted. Without a constant supply of energy the brain cannot function properly.
Inflammation: Caused by inflammatory chemicals released by the damaged cells and by over activated immune cells in the brain called microglia. This results in further cell damage and disruption of the blood brain barrier (a barrier that is very selective about what it allows to pass into the brain). The over activation of the microglia has been shown to last for decades…., yes, decades after an initial head trauma causing a constant low level inflammation in the brain.
One way to understand this situation is to liken it to a smoldering fire that may persist for years until it is extinguished by neutralizing the ongoing excitotoxic, inflammatory, and oxidative processes as well as the massive energy crisis. The sooner it is extinguished the less long term damage will occur.
A successful nutritional program for concussion must address all of these processes at the same time! Energy crisis, Excitotoxicity, Oxidative stress, Mitochondrial dysfunction and Inflammation