Brain Injury Awareness
BRAIN INJURY AWARENESS
For more than three decades, the Brain Injury Association of America (BIAA) has led the nation in observing Brain Injury Awareness Month by conducting a public awareness campaign in March of every year. According to the BIAA there are more than 5.3 million children and adults in the United States who are living with a permanent brain injury related disability.
The yearly statistics are staggering with over 3.6 million people suffering from an acquired brain injury and 2.8 million of these injuries being traumatic. Statistically, the breakdown of traumatic brain injuries are: 47% falls, 17.1% hitting or struck by an object, 13.2% from auto accidents, 13.2% unknown causes, and 8.3% from being assaulted. To put this perspective these statistics only relate to those brain injuries that are reported.
Traumatic brain injuries typically are caused by an impact of force to the head or body. Unfortunately, the brain does not fully mend itself as easily as when we get a cut or injury in other parts of our body. Granted, the brain with its skull covering is significantly better protected then most other areas of the body. The problem is that even if you have a very delicate object in a strong container like a wooden box if that box is knocked around a fragile object is most likely going to suffer breakage. This has become evident that even with good head protection, like a football helmet, players especially under 25 years of age can suffer serious ramifications from even one concussion.
Traumatic brain injuries can be from natural causes as when a pregnant woman has a prolonged labor and a newborns head is impacted by prolonged contractive forces of the mother’s pelvis. This is especially seen in such pregnancies that eventually necessitating a mother to undergoing a C-section delivery. Such prolonged compression on the newborns cranium can have effects on various cranial nerves. This is seen after delivery with such symptoms as the newborn being challenged with their suckling reflex, preferring one breast over the other due to neck pain, not able to hold their milk down, and just being a generally irritable and a fussy baby due to being uncomfortable and in pain.
As the infant gets older other causes of brain injury relate to the more familiar falls and injuries that occur in life. I feel that especially with children many of these injuries go unnoticed because there might not be an adult around to notice or that they are not reported to the parent. Of course, unfortunately, we cannot forget that many are intentional from other children and even uncaring adults.
Once an individual is able to communicate it becomes easier for a family member or friend to suspect that a brain injury has occurred from any obvious change in either personality or inability of the injured person to do a task they usually are proficient at doing. The most basic evaluation can be when an individual is acting confused or unusual after an accident. Next, evaluating a person regarding common things like their name, who you are, what just happened, what date, or time is it now. Other concerning signs are dizziness, visual changes, and of course neck pain, headache, and/or bleeding.
The first thing to do at an accident is to get the person to sit or lie down to prevent them from falling and doing more injury to themselves. Obviously, along with that is to try to stop the bleeding, if present, by applying pressure and getting help from those around along with calling 911 for help. One of the most important things is to keep communicating with the individual along with keeping them awake if at all possible. By being awake one can best monitor their situation and differentiate between just sleeping versus being unconscious in a coma.
As an Osteopathic physician I have specialized training in both the evaluation and treatment of injuries to the brain and central nervous system. In fact, one of our founders' students, William Sutherland D.O. conceptualized Cranial Osteopathy by revealing that the skull actually is made up of 22 boney plates in the adult skull that ideally move ever so slightly in a rhythm to help facilitate the circulation of spinal fluid, blood, and effective sinus drainage. Dr. Sutherland referred to this cranial rhythm as the “Primary Respiratory Motion” in that it literally drives the hearts circulation and the signals the lungs to breathe.
With any sort of head trauma one typically suffers from a whiplash due to a roughly 10 pound skull putting a straining pull on cervical and upper torso muscles attached to our skull. In fact, I have found that relaxing the tension in these muscles is the first way of getting stability and circulation of the head back to normal. The most critical junction of the body I feel is between the bottom of our skull and the first two neck vertebrae. The vast majority of chronic problems in the upper part of our body is due to chronic tightness of these muscles all around the base of our skull. Evidence of reduced motion of the head is inability to look straight up to the ceiling and/or move our jaw to each shoulder.
In a child the plates of the skull are over 30 in number and made out of softer cartilage which do not harden until one is in their mid-twenties. This alone is why brain injuries and concussions are so concerning and vital to treat. The easiest to evaluate brain injury in a young adult is when there is any obvious deficiency in any physical or mental task that they were proficient at prior to their injury.
In the adult skull many of these bones join and solidify into bone, but most importantly still need to move ever so slightly for optimal health. Lack of cranial bone motion contributes to chronic fatigue, dizziness, headaches, migraines, tinnitus, TMJ, visual disturbances, and many other neurological conditions such as Multiple Sclerosis. These conditions can relate to a combination of an imbalance of spinal fluid circulation along with neurological impingement of one or more of the twelve cranial nerves.
So after first reducing tension of the muscles supporting the head I next need to free up motion between one’s skull and upper neck in order to most easily reduce the tension between various cranial plates or bones. The edges of these bones have saw-like grooves that connect with each other like gears of a watch allowing for motion. In fact, it was the anatomy of the bone around the ear that Dr. Sutherland felt looked like a gill of a fish that prompted him to think there was motion present along those grooves known as cranial bone sutures. A most interesting fact is that NASA scientists accidentally discovered cranial bone movement during their meticulous measurements of their astronaut’s skulls during training noticing a rhythmic changing of volume.
Many Cranial Osteopathic techniques involve using a decompression force between adjacent cranial bones that are literally jammed together. The variations of the techniques are directly related to the variations of the cranial bone architecture. More than one Osteopathic physician has observed that if one studied the architecture of the skull one would see it reflected in every imaginal area of human architectural design. This is one more reflective evidence of God the master designer in that we are fearfully and wonderfully made (Psalm 139: 13-16).
What I want to leave you with is there is much that can be done to help heal brain injury and every individual that is still having symptoms, even if years later, deserves a trial of Cranial Osteopathic Therapy. I suggest an initial trial of six visits ideally one to two times per week with the goal of observable improvement seen by the patient. When one sees improvement then treatment will be continued spreading out the visits to every one to two weeks till function is at a level of patient satisfaction.