Austin Colbert/The Aspen Times
Traumatic brain injury (TBI) affects millions of people in the United States every year, but here in the Valley the number is higher than the national average. When Allison Pattillo, publisher of The Aspen Times, asked the audience at The Longevity Project event to raise their hands if they had suffered a brain injury, several hands went up.
Colorado ranks ninth in the nation for TBI-related deaths and 13th for TBI-related hospitalizations, according to the Brain Injury Alliance of Colorado. A Craig Hospital study estimates that Region 12 in Colorado, which includes Pitkin, Eagle, Summit, Jackson, and Grand counties, ranks first in head injuries after adjusting for population.
For this reason, The Longevity Project, an annual campaign dedicated to educating readers on what it takes to live a long and healthy life in the high country, has focused on brain health and injury.
On Thursday, November 10, The Longevity Project event was held at TACAW and featured expert brain health panelists. The event and series was a joint campaign between The Aspen Times and Glenwood Post Independent.
Panelists included Dr. Kathy Beauchamp, neurosurgeon at Denver Health’s CU School of Medicine; Dr. Kerry Brega, neurosurgeon at CU School of Medicine Rocky Mountain Regional VA Medical Center; Dr. Krista Fox, occupational therapist and board-certified brain injury specialist at Aspen Valley Hospital; and Dr. John Hughes, founder of Aspen Integrative Medicine. Lee Tuchfarber, Founder and CEO of Renew Senior Communities, moderated the roundtable.
The doctors discussed the topic of brain injuries extensively, sharing information on how concussions are diagnosed, brain injury myths, the latest research advances, and how brain injuries are currently treated.
What is a brain injury?
The brain has over 100 billion nerves in the central nervous system, all working together to control everything that happens in the body. Dr. Brega described Brain as an old switchboard, back when operators had to forward calls with lots of plug-ins and extensions.
With that, she described a brain injury as one or more of those jerked holds, causing a temporary outage of “service.”
The plug-in analogy also serves to explain how brain damage is different from person to person, or how brain damage can impact the same person differently over time. Simply put, not everyone who suffers a brain injury will shake the same plugs.
This variance leads to people affected by brain injury having very different symptoms and experiences, making it a difficult injury for doctors to diagnose.
How are brain injuries diagnosed?
Diagnosing concussions has come a long way over the decade, but the process remains quite subjective. While Dr. Hughes describes a brain injury as a bomb that explodes in the brain, the injury is at the molecular level, leaving concussions undetected on CT scans.
“By definition, if you can see blood on a CT scan, you don’t have a concussion,” Dr. Beauchamp said. “You have a mild to moderate or complex brain injury.”
Years before, loss of consciousness was thought to be the only way to tell if someone had suffered a brain injury, according to Dr. Brega. Doctors now know that loss of consciousness box means brain damage has occurred, but it is widely accepted that being knocked out is not the only indicator. In fact, according to Brega, most TBI patients she sees do not experience loss of consciousness.
Therefore, when trying to diagnose a brain injury, doctors rely on a patient’s symptoms. This is tricky, given that the symptoms of brain damage vary widely. Those who suffer a brain injury may experience mood swings, headaches, problems concentrating, changes in their balance or vision, changes in the inner ear and more.
Many who experience brain injury may not even register that a TBI has occurred. Months can pass before a person seeks treatment for their injury. Therefore, doctors recommend seeking treatment as soon as possible, in order to speed up the recovery process.
How are brain injuries treated?
With the different symptoms and range of TBI injuries, the process of treating the injury also varies. According to Dr. Fox, a doctor’s job is to figure out which system is most affected and how best to treat that system.
A brain injury is completely different from other bodily injuries, and not all brain injuries are the same. This makes treating a brain injury completely different from treating other types of injuries.
“A lot of doctors tell their patients to go home and rest, but the brain doesn’t rest. Not like other parts of the body,” Dr. Hughes said. “Your brain is still working.”
With this, Dr. Fox recommends that patients, especially those who were very active, do some form of physical activity soon after being injured, if they can.
The brain injury recovery process can range from a few months to the rest of life. Therefore, treating a brain injury is an ongoing process for many, according to Dr. Hughes.
“The beauty of neuroplasticity is that you can always get better,” Dr. Fox said.
The future of diagnostics
While the current state of brain injury diagnosis remains quite subjective, advances in medicine are still ongoing. The future of diagnostics could look like an app on your phone or the use of virtual reality glasses.
For now, a huge breakthrough in medicine is the change in perception of concussions.
Years ago, if someone had a concussion, we thought it wasn’t that bad. Now the issue of concussions is gaining in relevance.
“I think we’ve made huge strides in diagnosing it as we are, with the symptoms we know and the mechanisms we know, and teaching everyone that ‘it’s a concussion’ and that this needs to be treated as a serious issue,” Brega said.
Dr. Brega suggested that there are countless studies aimed at creating tests to definitively diagnose a concussion. However, many tests are still in their infancy.
According to Dr. Fox, two tests have recently been approved by the FDA. When these tests will be widely available remains unknown.
To reach Kristen Mohammadi, call 304-650-2404 or email kmohammadi@aspentimes.com.
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