There is evidence that head injuries can indeed lead to delayed
symptoms such as anxiety attacks, depression, and phobias. The onset
of symptoms from traumatic brain injury or postconcussion syndrome can
be delayed, sometimes for years.
"While medical science has not determined the exact cause of anxiety
and phobia, recent research has pointed towards a likely head
trauma-induced origin for certain cases of anxiety disorders. Evidence
supports that trauma (in particular mild concussive injury to the
head, neck or upper back) increases the risk of onset of anxiety and
phobia. Following the trauma, anxiety disorders can be triggered
immediately or can take months or years to develop."
Dr. Erin Elster
http://www.erinelster.com/anxiety_phobia.html
"...abnormal regional cerebral blood flow and reduced glucose
metabolism in anterior and posterior temporal areas being found in
subgroups of patients with persistent and disabling post-concussion
syndrome up to 5 years after injury..."
Medical Journals from Around the World
http://www.medical-journals.com/r03109c.htm
"A test may fail to show up any problems, but there may be tiny areas
of damage that cannot be seen. These can have a major impact on the
person?s life at home and at work in the weeks, months or years after
the injury... Many people are unaware that their earlier head injury
caused these problems, which are often called ?unseen injuries?...
Post-concussion syndrome can also cause problems for months or even
much longer after the injury, even if the head injury was a mild one.
Some people will have ongoing problems as a result of post-concussion
syndrome, and life can be very difficult for them and their families.
Some people develop problems immediately, others after a few weeks or
months or sometimes even longer. In some cases the person?s
personality may be affected."
National Electronic Library for Health: Head Injury
http://www.nelh.nhs.uk/guidelinesdb/html/Head_Injury/appendix.asp
"Post-concussion syndrome presents with headaches, spasticity,
dizziness, reduced coordination, sensory dysfunction, memory losses,
problems in concentrating, difficulty in perceiving, sequencing,
judgment and communication, fatigue, loss of empathy, depression,
anxiety, sexual dysfunction, depressed motivation, emotional
volatility, slowed thinking and impaired writing and reading skill.
Patients complain of trouble organizing thoughts, inability to express
themselves, difficulty selecting and recalling words, short-temper,
learning new information and retaining it, getting lost, confusion and
agitation. These are the same symptoms and complaints observed and
experienced by survivors of severe injury."
Tribute to Caleb: Traumatically Brain Injured
http://www.geocities.com/HotSprings/Villa/4197/brain.html
===================
-- TREATMENT --
===================
Various drugs have been used in treating the aftereffects of traumatic
brain injury:
"Drugs are sometimes useful in the management of traumatic brain
injury, particularly for mood disorders, such as depression and
anxiety. Regaining insight into the changes caused by TBI is often
accompanied by an increase in depressive symptoms. Depression is
common following TBI, with a reported prevalence of 10% - 60%.
Increased suicidal ideation has also been reported to occur for many
years after TBI.
The newer antidepressants, such as the selective serotonin reuptake
inhibitors (SSRIs), are most commonly used. Mood stabilisers (eg,
carbamazepine and sodium valproate) can be used to reduce the anger
dyscontrol sometimes exhibited by those with executive dysfunction.
When anticonvulsant medication is required, phenytoin is not commonly
used owing to its adverse cognitive effects, but carbamazepine and
sodium valproate can be used. Dopaminergic and psychostimulant drugs
have also been reported to be useful in a variety of specific post-TBI
syndromes. However, as with all psychotropic medication, care must be
taken to monitor the possible increased risk of seizures and reduced
cognition."
The Medical Journal of Australia: Rehabilitation after traumatic brain injury
http://www.mja.com.au/public/issues/178_06_170303/kha11095_fm.html
"There are no specific or reliable tests to diagnose PCS. A
neuropsychologist can perform an in-depth neuropsychologic assessment
that can determine presence or absence and extent of impairment. These
tests may be performed for medical purposes...
Treatment for PCS can be extensive. Medications for headache and pain
may be indicated (analgesics and muscle relaxants). Antidepressants
may be given to improve insomnia, irritability, or anxiety. Pain
control could be achieved with acupuncture, nerve blocks, or
transcutaneous electrical nerve stimulation (TENS, electrical
stimulation of muscle groups)."
Health A to Z: Post-concussion syndrome
http://www.healthatoz.com/healthatoz/Atoz/ency/post-concussion_syndrome.html
Here is a very interesting report on the use of EEG neurofeedback training:
"Research on persistent closed head trauma symptomology of depression,
mood swings, and/or anxiety attacks more than three years post injury
has been in the area of cognitive psychology, behavioral modification,
or psychotherapy. Often patients with persistent symptomology have
been described as neurotic, depressed, anxious, and perhaps symptoms
existed prior to head trauma. This controlled study of EEG
neurofeedback training and clinical psycho-therapy for right
hemispheric closed head injury attempted to determine if behavior
could be altered...
Psychologists reported that the six right head trauma individuals who
received only psychotherapy did not improve in mood swings, explosive
anger outbursts or anxiety attacks. However, clients reported better
understanding of how to cope with their problem. According to testing
with the Levin, Benton, and Grossman follow-up interview questions and
psychological report, individuals who received EEG neurofeedback
training along with psychotherapy had their mood swings, explosive
anger outbursts, and anxiety attacks subside. In addition, when EEG
neurofeedback was introduced after one year of initial psychotherapy,
subjects and psychologists reported progress in therapy."
Neuropathways
http://www.neuropathways.com/publications/eegneuro.html
More on EEG neurofeedback:
"The symptoms which accompany a head injury include loss of energy,
headaches and chronic pain, dizziness and vertigo, memory impairment,
difficulty concentrating, anxiety, depression, and mood swings, sleep
disturbances, irritability, visual perception problems and dyslexia,
and even apparent personality changes. Seizures may also be observed,
or seizure-like activity such as auras. If persons exhibited certain
weaknesses before the injury, such as Attention Deficit Disorder,
migraine headaches, or sleep difficulties, then such symptoms might be
considerably exacerbated by the head injury. The apparent severity of
the injury, including the length of period of unconsciousness (if
any), has little to do with the severity of subsequent symptoms. New
symptoms may arise months or even years after the head injury.
Over the past 10 years, we have experienced clinical evidence for the
effectiveness of Neurobiofeedback(sm) training as an adjunct modality
for remediating the symptoms of traumatic brain injury. The training
appears to be effective even years post-injury, when spontaneous
remediation is no longer expected. Neurobiofeedback(sm) can impact
favorably on all of the symptoms listed above."
Michigan Institute for Neurobiofeedback
http://www.expertsinmind.com/phy/11.html
EEG Neurotherapy with Vision Therapy:
"Mild traumatic brain injury (mTBI) typically occurs when the head is
suddenly accelerated and/or decelerated during an accident of some
type. There may or may not have unconsciousness, or even a blow to the
head... Clinically, mTBI patients usually show emotional instability,
impaired concentration and memory and reductions in their ability to
'multi-task,' that is, to keep on top of several things at once. They
also usually show a dramatic drop in their visual processing
ability... 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)...
We... employ a behavioral/developmental optometrist to assess the
vision system and to prescribe a treatment plan which corrects the
visual abnormalities. We have consistent success with this treatment,
which is applied along with the neurotherapy... to correct the
abnormal brain function."
Behavioral Medicine Associates, Inc: Mild Traumatic Brain Injury
http://www.qeeg.com/mtbi.html
Chinese herbal therapy has many enthusiastic proponents, although I am a skeptic:
"Post concussion syndrome (PCS) is a common but controversial disorder
that presents with variety of symptoms including-but not limited
to-headache, dizziness, fatigue, and personality changes.
PCS occurs in approximately 23-93% of persons with mild to severe head
injuries. There is no accurate correlation between the severity of
injury and the development of PCS symptoms, since signs of the
disorder can occur in someone who was just dazed by an injury...
Herbal treatment designed to stop pain and improve symptoms, prompt
mental recovery, slow disease progression, prevent and treat later
disease, improve the prognosis, and most importantly, to build
function. The purpose of herbal treatment is not to take the place of
necessary orthodox medical treatment. Combination of the both is a
better choice."
HerbChina2000
http://www.herbchina2000.com/therapies/NCS.shtml
Here you'll find an online manual called "Recovering from
Post-Concussion Syndrome: A Guide for Patients" that discusses the
physical, emotional, and cognitive elements that can occur after head
injuries:
Whiplash101: Post-Concussion Syndrome Manual
http://www.whiplash101.com/SchmitzManual.htm
Some books that you may find helpful:
"Coping With Mild Traumatic Brain Injury," by Diane Roberts Stoler &
Barbara Albers Hill.
http://www.amazon.com/exec/obidos/tg/detail/-/0895297914
"I'll Carry the Fork!: Recovering a Life After Brain Injury," by Kara L. Swanson.
http://www.amazon.com/exec/obidos/tg/detail/-/0933670044
"In Search of Wings: A Journey Back from Traumatic Brain Injury," by
Beverley Bryant.
http://www.amazon.com/exec/obidos/tg/detail/-/1882332008
Google search strategy:
Google Web Search: "post-concussion syndrome" + "treatment"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22post-concussion+syndrome%22+treatment
Google Web Search: "traumatic brain injury" + "treatment"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22traumatic+brain+injury%22+treatment
I hope this helps. Do keep in mind that Google Answers is not an
authoritative source of medical advice; the material I've presented
above is for informational purposes, and should not be taken as a
diagnosis, nor as a substitute for the services of a qualified medical
professional.
If anything is unclear or incomplete, or if a link does not function,
please request clarification; I'll be glad to offer further assistance
before you rate my answer.
Best wishes,
pinkfreud |
