Traumatic brain injury (TBI) typically occurs when the
is suddenly accelerated and/or decelerated during an accident of some
There may or may not have unconsciousness, or even a blow to the head.
A severe whiplash situation can cause the same kinds of twisting and
forces on the brain's axons - the nerve fibers connecting one part of
to another - as does a blow to the head. It is thought that these
damage the connections between nerve cells and possibly the conducting
fibers themselves, resulting in impairment of function.
Damage to the networks of connections in the brain also
with a stroke or surgery. A "stroke" means that either there was a
blockage in a blood vessel feeding a particular region of brain, or a
blood vessel broke open and bled (aneurism). There will be a local area
of damage from the cells not getting enough bloodflow. The piece of
brain that is directly damaged by the stroke will be impaired, at least
for a while, and won't be able to serve its normal function.
Beyond that there can be effects in regions the local area of damage is
supposed to communicate with. Many regions of brain perform regulation
of other regions, so if an area is damaged by a stroke or surgery other
areas - not necessarily nearby - can lose function because they're not
being regulated properly.
Brain can also be injured if a person is unable to breath
long enough, or if the heart stops for too long. This happens from lack
of oxygen and blood sugar getting to the brain cells. This is why it is
so important to provide emergency CPR at the scene, immediately. If you
do not know how to administer CPR, you should learn. Contact a local
hospital, fire department or medical clinic and ask how to get basic
first aid training including CPR. Even when the person is revived, the
brain may have suffered widespread damage, since all the cells need
oxygen and glucose to survive. Some are tougher than others in the face
of oxygen deprivation. The cells in the hippocampus, which is vital for
memory formation, are unusually sensitive to being deprived of oxygen,
so loss of ability to store new memory is very common in "anoxic"
(without oxygen) brain injuries.
There may be major depression and anxiety associated with these symptoms. In fact, these symptoms are often misunderstood by family and health care providers as "nothing but" depression, or worse still, malingering. However, the symptoms do not yield to standard medical treatment (cognitive therapy plus medication). That may be due to the injury of brain systems that support normal mood, or to irritation in other systems that support irritable moods, or to the failure of the medical and psychological treatment to provide adequate explanation of what's going on, adequate rehabilitation and hope. Cognitive behavior therapy helps people keep their thoughts useful and helpful to their recovery.
Finally, patients with brain injury from accidents usually have severe "trigger points" in the neck and back muscles, which cause chronic headaches. These headaches are not often cleared up by relaxation, chiropractic or passive physical therapy. Triggered muscle causes "myofascial pain" and the pain and dysfunction is often "referred" to other areas of the body. This is well described in the Trigger Point Manuals by Drs. Travell and Simon. The necessary treatment is compression and stretching of the affected tissue several times daily. This must be coupled with very deep autonomic relaxation. This is easy to learn and we teach most of our patients to self administer this treatment.The brain can repair itself
In the past we thought brain damage was permanent. We now know that there is birth of new cells going on in adult brains. In fact a stroke actually has been shown recently to be a stimulus for a higher rate of cell birth in animals. These new cells grow into the regions of damage and can help restore function. What's important is that the person get good nutrition, minimize stress (more about that later) and place a persistent demand on the brain to perform the impaired function(s). To understand the treatment we do and its efficacy, you must understand that the connections between our brain cells are extensively influenced by learning. In other words, we learn to construct the visual world as infants; we learn emotional control, strategies of attention, strategies of learning and memory itself. It is well established that these learnings cause the growth of new neuronal connections. We believe our treatments may, by rewarding new learning, promote the growth of new, "replacement" connections.Education regarding what has happened, how the brain functions, the effects of various types of injury begins our treatment. Relaxation training is a basic part, since excessive arousal from frustration, anger at the injury, etc. will make things worse.
We also assess
binocular vision and correct poor binocular control. We have consistent
success with restoring normal binocular control using guided practice
with binocular stimuli which is done along with the neurotherapy
(described below) to correct the
The sister technology to qEEG analysis is called EEG biofeedback, neurofeedback or neurotherapy. The qEEG provides the "targeting" information. That is, it tells us where and under what conditions (reading, listening, math, etc.) the problem is worst. This analysis allows accurate electrode placement for feedback and suggests the tasks that should be used during therapy. Neurotherapy is EEG feedback-assisted cognitive behavior modification. It couples EEG feedback with the full range of traditional cognitive behavior therapy methods, including imaginal rehearsal, correction of maladaptive thought patterns, and rehearsal of new skills. We commonly utilize intensely activating, challenging tasks (such as computerized stereo vision training, memory and reaction time challenges) during the sessions to enhance brain activation and teach what it feels like to be focused and functional again. The EEG feedback signals the patient when their brain is in fact in a more activated state, indexed by decreased delta and theta brain wave amplitudes, and increased beta and/or alpha amplitudes.
Neurotherapy is no panacea. Like any therapy, it works
the smartest, least brain damaged patients. Patients with profound
loss which prevents the acquisition of new learning at all are not
to be helped. On the other hand, patients with emotional dyscontrol,
memory and concentration, and a good pre-morbid level of functioning
responding very, very well to the treatment. Most interestingly, good
are being achieved in patients who are 2, 3 or even 5 years post
these are times at which improvement cannot be attributed to
recovery." We have documented improvements on standardized memory tests
of several standard deviations, showed essential normalization of
Our patients report reading returns to normal and they find the visual
world no longer confusing. Patients, family and physicians have
improved alertness and reduction or elimination of emotional
and depressed mood. We have had patients tell us they feel "back to
in as few as 20 sessions. We have seen objective improvement in visual
processing, memory, attentiveness and emotional stability even years
injury. We suspect this treatment works best with the smartest people
have the least damage. We encourage patients and their families to
that this is a new approach, with little formal outcome research to
it works. There is no guarantee it will help any particular individual.
The treatment is non-invasive, doesn't appear to have any negative
doesn't involve drugs, and over 95% of the people we've treated rate
50% improved or more. With this improvement rate is so high,
patients who could not possibly be undergoing any "spontaneous
recovery" years after their injury, we believe we have clear evidence
this treatment helps.
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