HEAD INJURIES—LINGERING EFFECTS?
One week ago I took a hard fall onto my head. I was simply rolling out my trash barrel to the street, twisted to maneuver it, stumbled on a rock in our garden and fell straight backwards onto my concrete driveway. I hit so hard that I felt my head bounce. And I was bleeding so badly that JoAnne made me jump in the car and then drove me straight to an urgent care facility. But they said that with my head injury I actually needed to go to a hospital emergency room. And off we went.
Fortunately, there were no other patients there when I arrived. They quickly asked if I had a concussion, if I had lost consciousness. I answered that I hadn’t. Then I was wheeled into an examining room where they cleaned up my bleeding, patched my wound and bandaged my head. I also had a MRI. I was instructed to see my personal physician, which I did the next day.
I had to postpone putting in my vegetable garden, which I had planned to do last weekend. I also haven’t been able to ride my bike or go for long runs. But now here I am a week later. I was able to remove all the bandaging around my head and replaced it with just a couple of large band aids over the wound itself. I jogged a bit yesterday. Very slowly. After the first 10 minutes I began feeling woozy so I changed to walking for a while. I was finally able to put in another 10 minutes—which was quite enough.
I’m more worried about complications down the line than I am problems right now. I began looking up possible scenarios and found an online October 2015 AARP Bulletin article by Mike Tharp, Are Old Head Injuries Fogging Your Brain? Here is what I found relevant to my injury but also may be of interest to you if you’ve had a head injury sometime in the past and wonder about its long-term consequences:
Many older Americans whose head had trauma earlier in their lives may begin to manifest itself after they turn 50. Scientists divide such trauma into transient brain injuries — where symptoms dissipate after seven to 10 days — and more severe traumatic brain injuries that have long-term cognitive consequences.
The symptoms of delayed brain trauma have been recognized in professional athletes for years. Tony Dorsett, 61, is a Hall of Fame running back who played with the Dallas Cowboys. After a concussion-filled career, he’s been diagnosed with serious brain trauma. “I’m doing pretty good, for the most part, I guess,” he says.
He urges people over 50 to “stay active, keep reading, do puzzles, go to movies, talk about books — the thing to do is engage people.” He also advocates exercise — “get that adrenaline flowing, that rush through your body, that blood to your brain.”
Less well documented is the lingering effect of early brain trauma related to head injuries on ordinary Americans.
Not just jocks
“This problem is not unique to athletes,” says Robert Cantu, a clinical professor in Boston University’s Department of Neurosurgery and a senior adviser to the National Football League on head and neck injuries. “Repetitive head injuries can be the result of physical abuse, car accidents, multiple falls. You may be at risk for CTE [chronic traumatic encephalopathy] later in life.”
CTE and related head injuries can lead to short-term memory problems and difficulty in making reasoned judgments and decisions. For a person in his 50s or older, these symptoms could be the result of head trauma.
“If you had a loss of consciousness earlier in life, there may be greater likelihood of the onset of cognitive changes later in life,” reports Munro Cullum, professor of psychiatry, neurology and neurotherapeutics at the University of Texas Southwestern Medical Center in Dallas.
Recovery time among older people is dramatically different from younger patients. David Cifu, director of physical medicine and rehabilitation programs for the national Veterans Health Administration and chairman of the physical medicine and rehabilitation department at Virginia Commonwealth University School of Medicine in Richmond, estimates that those over 55 who suffer a moderate to severe concussion recover to about the same degree as younger patients. However, he observes, the recovery time may be twice as long as that for younger patients — a year or more for some seniors.
For example, seniors who have been injured in falls or accidents involving brain trauma “don’t bicycle as well or walk as fast as they did” before the injury, Cifu says. “Clinicians shouldn’t give up too soon — and families shouldn’t either.”
Long-term effects
Kevin Audley, 50, a counselor in Olathe, Kan., was a 20-year-old University of Kansas student in 1985 when he fell 2 1/2 stories from his frat house to the concrete sidewalk below during a party. He didn’t know the punch was spiked with grain alcohol. He spent a week in the intensive care unit. Besides injuries to both knees and his elbow, he also suffered a concussion.
Today he’s a successful contributor to books, has launched several websites, counsels dozens of clients — but has trouble remembering what a friend had for lunch. “I don’t hit the save button for my short-term memory,” Audley says.
Deep brain stimulation
Americans over 50 who suffered what doctors call a “single uncomplicated” concussion earlier in life usually don’t have to worry about cognitive impairment later, says Amy Jak, associate professor in residence in the Department of Psychiatry at the University of California in San Diego. She adds, however, that those who suffered a “moderate to severe traumatic brain injury may raise the risk factor.” She cautions that other health factors may also elevate the risk: high blood pressure, diabetes, genetics and mood. “You should manage your health concerns,” she says, “your mood concerns. Depression can also contribute to cognitive problems.” She strongly recommends exercise to promote and preserve mental health.
One intriguing new therapy still very much in the discovery phase is the use of deep brain stimulation (DBS) as a way to enhance memory. DBS has been used on patients with Parkinson’s disease, depression, epilepsy and other illnesses. It consists of implanting microelectrodes that send small shocks into specific areas of the brain to restore disrupted functions.
Kendall Lee, a professor of neurosurgery and biomedical engineer at the Mayo Clinic in Rochester, Minn., has been in the forefront of the application. He has called it “a pacemaker for the brain.” Research has just begun on the use of DBS for improving memory, but Lee believes that enough has been learned already to support further research. “It’s pretty far off,” he says, “but it’s very important that it is under investigation.”
And Tony Dorsett stays active by chasing Hawke, his year-old grandson. “He wants to get busy,” says Dorsett. “He was over here yesterday and we went for a walk and I’m telling him, ‘Slow down, slow down!’ “