Traumatic Brain Injury: Causes, Effects & How To Manage Symptoms

When thinking about some of the leading causes of death in this country, cancer and heart disease may cross your mind, but a traumatic brain injury (TBI) likely doesn't—or at least not right away. But TBI is a substantial threat to public health in the United States, contributing to 30% of all injury deaths1. In 2010 alone, 2.5 million emergency room (ER) visits, hospitalizations, or deaths were associated with TBI in the United States.

A TBI is caused by external force (e.g., a blast or fall) to the head, leading to disruptions in brain structure and function. It is also known as close head injury (CHI) and concussion syndrome (CS).

It has complex and pervasive long-term effects on a scale of 1 to 10, with 1 being a minor bump and 10 being something more severe like a car accident. No matter how minor the accident may appear, though, head injuries should never be ignored.

It is projected to become the third-largest cause of disease burden worldwide by 2020, which is why many people call it a silent epidemic. It is commonly accepted that the majority of TBIs are mild in severity and make up between 70% and 90% of all cases. This number is likely an underestimation, given that many TBIs are thought to go untreated and, therefore, unreported. 

TBI, a common injury in sport, military, and domestic environments, alters the fundamental aspects of gene regulation, which could explain mechanisms by which the TBI pathology can divert into other brain disorders2. The brain is not anchored to anything in the skull, so any bump will make the brain move, which can then cause it to hit the skull in multiple places, sending shock waves through the brain. This leads to diaschisis, which are mini lesions across the brain that can result in inflammation and mini hemorrhages.

Extended periods of inflammation are key factors in TBI. This happens when microglial cells (aka immune cells in the brain) increase in response to the injury. This inflammatory response is initially good, but if the injury is extensive, it will lead to an overabundance of microglia, and brain tissue can become damaged. This results in reduced activity in different parts of the brain—even mild brain injuries can cause sustained cognitive and psychiatric problems.

"Concussive brain injury reprograms genes, which could lead to predisposition to neurological and psychiatric disorders, and that genomic information from peripheral leukocytes has the potential to predict TBI pathogenesis in the brain3," write the authors of a 2017 study published in EBioMedicine. But there is research also showing these disruptions caused by a head injury seem to affect a master gene. This master gene "tells" other genes what to do. When affected by the head injury, the master gene can create confusion with other genes in the brain and may even change them long term.

TBIs also change the way energy flows through the brain: The genetic changes associated with TBI appear to disrupt brain activity over the damaged areas, which can be picked up by quantitative electroencephalogram (QEEG) technology, aka "brain mapping."

There are many symptoms of TBIs, including Alzheimer's disease, Parkinson's disease, post-traumatic stress disorder, stroke, attention deficit hyperactivity disorder, autism, depression, schizophrenia, and more.

One peculiarity of any TBI is that talents you had prior to the injury might be lost, and completely new talents could emerge in their place. There have even been cases in which someone becomes a savant following a head injury, such as a person affected with a developmental disorder (like autism or intellectual disability) who exhibits exceptional skill or brilliance in some limited field (i.e., mathematics or music).

There are also massive emotional changes associated with TBIs, including an extreme struggle to control or manage emotions. Many people experience frustration because they often remember how they used to function. They also experience language change, such as tangential speech and/or word-finding—needing more words to explain themselves, overexplaining, oversharing, becoming frustrated when people don't understand them, feeling easily triggered in emotional situations, and/or feeling like they cannot control voice tone or body language well—especially when triggered.

Through my research over the past 30-plus years in the field of neuroscience, and my experience doing directed mind work and brain-building, I have observed significant improvements in cognitive, psychosocial, emotional, and intellectual functioning when individuals with TBIs are taught to manage their symptoms. Recent research from the University of Texas at Dallas suggests that training-induced neuroplasticity (aka the ability to change the brain) continues through chronic phases of TBI and that brain connectivity and cortical thickness may serve as markers of plasticity4.

Brain-building is basically when we use the mind to remodel the neurological coding in the brain (specifically in our dendrites), and this happens through intentional and deliberate mind-directed thinking. This kind of thinking can be described as an energy surge that causes electromagnetic, genetic, and chemical changes in the brain. It stimulates neurogenesis, i.e., the birth of new brain cells, which help prevent and heal cognitive decline and combat the negative effects of diaschisis. 

Brain-building includes intense, systematic, and deliberate small steps that are intellectually challenging and fun, which exercise both the mind and brain. By doing these types of exercises, we are tapping into something called regulatory genes.