A Concussion Is More Than a Bump on the Head – The Hidden Brain Changes That Can Last for Years with Dr. Aaron Hartman | Concussion | E160

So there's 1.7 million traumatic brain injuries in the United States every year, 275,000 hospitalizations. And this is according to the CDC using their traditional definitions. Think about how many kids play soccer, how many kids play football, how many people ride roller coasters, how many car accidents are. These numbers are definitely higher than this, but it gives you an idea that recorded by the CDC, 1.7 million TBIs. That's a pretty big number. Welcome back again to another episode of Made for Health. We are going to dive into almost short series on concussions, traumatic brain injuries, what these actually are, you know, a brain on fire. Did you know that a, even a mini concussion is a small brain on fire phenomenon? So why are we talking about this? We actually had many people on social media ask about brain injuries in relationship to Lyme and a bunch of other things. So we decided to kind of take a little path down talking about traumatic brain injuries, concussions, microconcussions, and the whole host of things. Because ultimately, if your brain's on fire, it affects your entire body. And a lot of people don't realize that a small injury you may have had, inconsequential, 6 months, a year ago when you were playing soccer or another sport in high school could be affecting you today. Before we dive into things, just some quick housekeeping. If this information is helpful, please like, share, follow us. That really helps us get the news out there, get the word out there, and also helps us know what topics people are interested in so we can focus on what's actually more helpful to people. So let's dive into the first part of this series on traumatic brain injuries. So it's really interesting. You know, what could— I want to start first with a story of an actual patient that I saw, a young male, late 20s, that came to me with a lot of weird health issues, chronic fatigue. He had some Lyme issues, all the usual things. His gut was really bad off. We kept on getting stuck with his evaluation. Eventually we did a specialized test called a NeuroQuant, which was a volumetric, a special MRI to look at his brain. And it had signs of a traumatic brain injury. Come to find out he played soccer competitively in middle school and high school and had gotten all these small micro concussions that set him up for that tick bite that set him up for a lot of his health issues. And so knowing that past, knowing the nuances, a concussion is not just getting your, your lights knocked out, which is what we used to think when I started my training. It could be something as simple as a little bonk on the head that makes you dizzy for a little bit, but in the right situation can cause health concerns. So what you want to keep that in mind is a whole spectrum of concussions, microconcussions, traumatic brain injuries. And the thing about these, they can also activate your nervous system like a trauma, physical, sexual, emotional abuse kind of thing, but it's from a traumatic thing to your brain and nervous system. So there's a lot of nuances to this. Hopefully this will help— is helpful to those out there who are suffering with this. And also, I mean, it's amazing how many people actually have concussions. So let's first start talking about what is a traumatic brain injury versus concussion. You know, traumatic brain injury is an external force to your head that disrupts normal brain function. So that's a pretty generic thing. That can, it can have altered nervous system status. You can be unconscious or you can just have your bell rung. You know, when I did a lot of sports medicine during my training, we would have like football, we'd be on the sidelines with football players. They get a hit, they come out, they're buzzing, tingling. You know, you ask them, hey, what play did you just do? I don't know what play I just did. You know, why don't you count backwards by 7s? They couldn't do basic math. You know, hey, your brain is being affected by this. You pull them out of the game until they got back to quote-unquote normal status.

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We now know that's actually probably not the right thing to do, but that's a small traumatic brain injury. Concussion is actually, is the description of the effect of that brain injury. The concussion itself is the, you know, the fancy word is the neuropsychological pathological process of altered brain cognition function from the brain injury. So the concussion itself is the symptoms afterwards, and you do not have to have a loss of consciousness to have this. It could be Confusion, dizziness, headaches, visual disturbances, even mood alterations, all are part of concussion. And something we, a lot of times we use the word concussion, traumatic brain injury interchangeably. That's the pretty standard, but there, there are some nuances to it. But the key point is, I think here is that concussion is not a structural issue. You get a brain MRI done and it looks 100% fine. When I did my training initially, our biggest concern was brain bleeds. And so you thought someone had a brain bleed, they go that, you know, after a football game or a car accident or whatever. You would go to the hospital, get a CAT scan done, which is the best, quickest way to see the brain bleed. It's normal. You're fine. And even on an MRI, it's not going to pick up the small nuances of an injury from a concussion and traumatic brain injury. So that, I think that's a major thing is you can have an imaging test that's normal and still have a significant brain injury. The other concept is your primary versus your secondary injury. The primary injury is like the first direct structural damage, the thing that you hit, the car accident. Um, actually one patient who was at Home Depot looking at cabinets, leaned up, hit the back of her head on an open cabinet, and that was her traumatic event that resulted in around 3 months of post-concussive syndrome. That's the initial primary thing. The secondary injury is the inflammatory process that occurs after the injury. And this is where a lot of the science is and where a lot of the complication is, because you might have a small event that seems small. But the secondary injury, the inflammation caused by that, with— you can't do math anymore, you have mood problems, you can't focus, your sleep is disrupted, you have mood changes, your gut's a wreck. And actually, patients actually have concussions and have their skin gets affected because every concussion you get basically leaky brain and leaky gut. And that affected their immune system and ultimately their skin because there's a skin or gut-skin axis. So point being is a lot of nuances behind concussions and brain injuries that aren't talked about traditionally that we see in the neurologic, in the functional neurology, I call it functional neurological world. And this is also where a lot of treatments sit. If you have a brain injury, now you've got gut issues, you have skin issues, you have mood changes, you're going to be doing neurotransmitter testing, nutritional testing, a whole host of other things related to your symptoms you're having. And then knowing you have a brain injury affects what we actually do for that. So what's the spectrum of traumatic brain injury or concussion. I will use these words basically interchangeably. It can be from a ding, a small, you know, like I mentioned, someone hitting their head at a cabinet at Home Depot to chronic traumatic encephalopathy or CTE. If any of you have seen the movie Concussion, you know what I'm talking about. It was actually about, you know, basically the boxing world, people, boxers, professional, you know, boxers getting hit and developing mood disorders, actually some becoming suicidal or homicidal.. And ultimately that was not their— it was a brain injury, traumatic encephalopathy. For those of you who are familiar with Dale Bredesen's work on dementia, there are, you know, 6 types of dementia. Type— the last type, it's like type 1, 1.5, 2, 3, 4, 5. Type 5 is actually dementia develops after concussions and the post-injury inflammation continues and you actually get breakdown of your brain over time. And so there's a kind of dementia. Related to these kinds of injuries. Chronic traumatic encephalopathy is a more severe version of that where people have significant mood issues. And you tend to see football players a lot. There was a lot publicized with football players, but again, you go from a ding, a small little hit, soccer player, backyard, you know, football, hitting your head, you know, roller coaster. Actually, in one patient, she was an executive in her 30s who got after riding a roller coaster. That's what she, that's how she developed her. It was actually here in Richmond at Kings Dominion. And the roller coaster actually became known for this and eventually got shut down, obviously. But the point is just pulling G-forces on your head and susceptible individuals can give you a micro concussion that can affect your health. And so knowing all these nuances helps individuals know, hey, there's more to this concussion here than just, you know, I didn't get my lights knocked out. And you know, that small fender bender that I'm now having sleep problems with, that is a concussion or micro concussion or whatever terminology you want to use for that. And the other thing to think about is the repetitive injuries, even if they're small. You know, I remember reading this statistic that the average front linebacker— and they actually put G-force measuring devices in football players' helmets— gets like 20 microconcussions on a Friday night playing football. For those of you who are in soccer know that in the United States, they changed the rules for kids playing soccer. I believe it's 12. None of my kids play soccer, so I'm kind of— say anything, it's 12. They won't allow kids to head the ball. Because you will get a micro concussion. A young brain is more susceptible to this. So all of a sudden, these small little things over time can add up. And you have to kind of know that when you're looking at an individual and you're, and they're coming in with their sleep disturbances, fatigue, fibro, body pain, hormone abnormalities, mood instability, gut problems, diarrhea, constipation, you know, or it could be they're doing fine. They got the tick bite. They got a mole hit, they got a stomach virus, and all of a sudden their symptoms look so like, why would this— you get all this from this minor— you got flu, you got COVID, right? And all of a sudden, or flu or something else, and all of a sudden your story doesn't quite sound right. The setup could be these small microconcussions over years or decades to set the person up. So now this virus that causes a little leaky gut and a little leaky brain is uncovering these old microaggressions or rage on the things. So that's why getting aware of this is super, super helpful.

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So some data on concussions. There's 1.7 million traumatic brain injuries in the United States every year, 275,000 hospitalizations. And this is according to the CDC using their traditional definitions. If you use the definition I just told you right now, these numbers are going to probably be 5 or 10x higher. Think about how many kids play soccer, how many kids play football, how many people ride roller coasters, how many car accidents are— it's just These numbers are definitely higher than this, but it gives you an idea that recorded by the CDC, 1.7 million TBIs. That's a pretty big number. You know, here's a great number. 38 million kids and adolescents are organized sports. You know, how many of those kids are getting small little injuries? And 170 million adults do some kind of physical activity. You know, if you're pulling Gs, if you're doing things, you fast acceleration, deceleration in certain situations can set you up for these micro concussions. And the most fertile age— this is important— is between 15 and 17 years old. Lean between 0 and 4, and it's males more than females. That kind of makes sense. Between 0 and 4, kids fall a lot, hit their heads on things. 15 to 17 makes sense because it's the more active age of people's lives during adolescence. The males more than females makes sense because males tend to do more aggressive sports and take more risks. So, these things kind of make sense. Sports associated with it, of course, football, of course, soccer. Hockey is becoming more popular. Lacrosse, rugby. You know, it's really interesting. I see a lot individuals, actually a lot of females who ride horses. How many times have you been thrown off a horse? How many times have you been kicked by a horse? And, you know, people who are with horses are tough. They are used to walking around on broken feet. My next-door neighbor actually, you know, one time one of her horses stepped on her foot, broke her foot, went to get the ortho on call. Next day she's out there in the pasture putting up fences, and because she's like, someone's got to do the work, right? And so people, particularly females, who are involved with equestrian horse stuff Tend to be used to getting beat up and kind of moving on. And unfortunately, these are all things that can set you up for these microconcussions and skiing. I just, some examples of things. The point is, is this is a silent epidemic that is largely overlooked. That we're not paying attention to that in my world of integrative functional medicine world affects a lot of people. So having on your radar, if you've just finished listening to this 10-minute, you know, quick, short little 12-minute thing, I hope you appreciate that these small injuries can set you up for a whole host of other things. So we're going to keep on with the next 5 or 6 episodes talking about this and the nuances of traumatic brain injuries and concussions. Because the reality is just look at the numbers, you know, 38 million kids in sports, you know, 1.7 million actual recorded TVIs. We all know someone who's had a brain injury of some sort, whether it's just a small concussion or something more serious. So being aware of this and having it on your radar is super important. Anyway, we'll keep on going with this series. I just want to remind everybody that the reason we're doing this particular series is because people actually asked for I'm supposed to talk about brain injuries and concussions. So that's what we're doing. Hope this information's helpful, educational, and take care. We'll talk to you soon.

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