What is a concussion?
Not too long ago, you were considered to have a concussion only if you lost consciousness from a head injury. In fact, not only do you not have to lose consciousness (research suggests only 10% of people do), but you don’t even have to hit your head. Many of the concussions in military personnel have occurred from the force of an explosion, not from a direct blow to the head. We also know that many concussions happen during whiplash injuries, like a car accident or in an infant that is violently shaken.
Concussions are the most common type of traumatic brain injury and are often referred to as mTBI. Concussions cause a variety of physical, mental, cognitive, and emotional symptoms, which may not be recognized if subtle. People who have had one concussion are typically more prone to another concussion, often with less severe trauma. This is especially true if the new injury occurs before the previous concussion has resolved. Multiple concussions may increase the risk for dementia, Parkinson’s disease, and/or depression later in life, and are associated with chronic traumatic encephalopathy or CTE (CTE can only be diagnosed after death at the time of this writing).
Head injuries have a primary and secondary component.
The primary component is the immediate damage the brain sustains from the trauma. This includes bruising of the brain and some possible bleeding, shearing and tearing of nerves, other brain cells and blood vessels. A substantial amount of nerve cell death begins within hours of the primary injury.
The secondary injury component starts within minutes of the trauma and may go on for years. This secondary component involves chemical reactions and abnormal brain cell functioning and this is where the nutritional approach works.
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 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