Our Changing Brain Neuroplasticity is an umbrella term that refers to changes in neural pathways and synapses in the brain due to changes in behavior, environment, neural processes, thinking, and emotions, as well as changes resulting from bodily injury.  This occurs on a variety of levels, ranging from cellular changes due to learning, to large-scale changes involved in cortical remapping in response to traumatic brain injury.  Think of it this way. Your brain is not a “static” structure.  It’s a dynamic and ever-changing organ with seemingly a life of its own, not unlike a standalone organism.  Initially, the brain goes

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Post-Traumatic Amnesia

What is Post-Traumatic Amnesia? Post-traumatic amnesia (PTA) is a state of confusion that occurs following a traumatic brain injury or concussion in which a person is disoriented and unable to remember certain things associated with the event itself and/or remember things before and after the event.  The term is also used in a broader context involving the inability of a person, after brain injury, to create new memories.  When continuous memory returns, PTA is considered resolved.  There are two types of amnesia: retrograde amnesia (loss of memories that were formed shortly before the injury) and anterograde amnesia (problems with creating new

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Glasgow Comma Scale

What is the Glasgow Coma Scale? The Glasgow Comma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury. Basically, it’s used to help gauge the severity of an acute brain injury. The test is simple, reliable, and correlates well with outcome following severe brain injury.  The GCS is a quick and mostly objective way of recording the initial and subsequent level of consciousness in a person after a brain injury. It is used be trained staff at the site of an injury like a car crash

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Coup Contrecoup Brain Injury

What are coup and contrecoup injuries? In brain trauma, a coup injury (pronounced coo) occurs on the side of the brain where it initially impacts the inner skull. A contrecoup injury (pronounced contra coo) occurs on the opposite side of the brain from where the coup injury happened and is the result of the brain recoiling from the original coup injury. Inertia forces to the head play a role in this type of injury. Coup and contrecoup injuries can occur individually or together.  When they occur together, they constitute a coup contrecoup (pronounced coo contra coo) brain injury. These terms

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Depression after Brain Injury

Cause and Frequency The exact cause of depression following traumatic brain injury is unknown, as it is generally, with many factors involved. What is known, however, is that depression correlates significantly higher in persons following brain injury than in the population at large. One in every six people will experience depression in their lifetime, but about half of all people with TBI will experience depression in the first year following injury. Even more (nearly two-thirds) are affected within seven years after injury. Statistically, that’s huge! Contributing Factors Factors after traumatic brain injury that contribute to depression are: Physical changes in

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Damage to the Blood-Brain Barrier

What is the blood-brain barrier? Ever wondered why when you get sick, bacteria and viruses don’t invade your brain? They can certainly find their way to other organs and different parts of your body, but why not the brain? The answer is the blood-brain barrier (BBB). The BBB is an extra layer of cellular insulation surrounding the capillaries in your brain. How important is this extra layer of blood vessel protection? In a word, “vital!” How extensive is the brain’s capillary network? Well, it’s estimated that nearly every brain neuron has its own capillary and the total combined length of

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Post-Traumatic Headaches after Brain Injury

Prevalence The overall incidence of TBI in the United States is a shocking 1.8 million cases per year, of which 30 to 90 percent, per retrospective studies, will have a post-traumatic headache (PTHA) component.  Fully 2 percent of the entire U.S. population is disabled secondary to headaches.  In addition, nearly 45 percent of head and neck injuries are accompanied by chronic headaches at six months, and at 1 year, headache pain is present in 20 percent of such individuals and is considered chronic.  It is no wonder PTHA is considered the most universally shared symptom of traumatic brain injury.  A

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Brain Swelling after Trauma

An Inflammatory Response The body reacts to injury, including brain injury, with a predictable inflammatory response. Swelling (edema) is a manifestation of that response and is the result of increased blood flow which brings white blood cells to the injured site, and the movement of other fluids, to help heal the injury. Edema is a sign of an underlying problem, but not the disease/injury itself. Brain swelling (cerebral edema), which can last up to 5 days post-trauma, can be in specific locations within the brain, or over widespread regions of the brain, and can be a direct or indirect response

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Brain Bruising (Hematomas)

What is a hematoma? A bruise (contusion), wherever located, is a collection of blood outside a blood vessel following trauma to that site. We are all familiar with contusions just underneath the surface of the skin following a bump or blow, but the brain can bruise too following trauma, with or without direct head contact, with the same accumulation of blood outside blood vessels. Brain hematomas and almost exclusively diagnosed by CT scans. These are serious conditions which require close monitoring, and in some cases immediate and direct surgical intervention. Brain hematomas can not only cause brain damage at the

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A Secondary Injury Process Not all brain damage occurs at the moment of trauma.  Far from it.  Brain damage occurring in that moment is considered a primary injury.  It’s generally held, however, that the most significant damage in the cycle of traumatic brain injury occurs after the primary injury with the onset of secondary injury processes placed in motion by primary injuries.  Excitotoxicity is one of several secondary injury processes and is a toxic condition in the brain caused by damage to brain neurons and to the blood-brain barrier.  Excitotoxicity is a highly complex and destruction injury process, and as

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