The chronic and evolving neurological consequences of traumatic brain injury

Lindsay Wilson, William Stewart, Kristen Dams-O’Connor, Ramon Diaz-Arrastia, Lindsay Horton, David K Menon, Suzanne Polinder
graphic representation of a neuron

Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the longterm consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease. With respect to neurodegeneration after TBI, post-mortem studies on the long-term neuropathology after injury have identified complex persisting and evolving abnormalities best described as polypathology, which includes chronic traumatic encephalopathy. Despite growing awareness of the lifelong consequences of TBI, substantial gaps in research exist. Improvements are therefore needed in understanding chronic pathologies and their implications for survivors of TBI, which could inform long-term health management in this sizeable patient population.

Posted on BrainLine August 7, 2019.

Comments (4)

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Yes as in any head trauma, be it sports accidents DV, stroke, a fall, or being beaten up at school. It happens. But most oftern the severity of the trauma isnt duly diagnosed until Post Mortem.

Please do take heed. Do you see a pattern, here? women's cry for right to medical care......
<GIVE US SOME DOCTORS AND THE RIGHT TO ACCESS THEM! TBI’S are not a psychological problem they are an injury! Why are we rushed to the psych ward subjected to further damage from psychoactive drugs and not treated for the actual injury? My opinion is that of ignorance on the part of the medical community> ...
I can only add to this:
- in Australia, there is NO WAY TO DIAGNOSIS;
-doctors display outright misogynist attitudes; WOMEN are DENIED MEDICAL CARE RIGHT.
My example:
My mother had a car accident, cracked skull & mTBI and they put her in therapy & CBT. Result: major inflammation event at birthing. Result:
I had TBI from birth too (violent induced, damaged skull & other bones, left a number of brain difficulties, incl. paroxysms), never addressed, lifelong afflicted with autonomic manifestations and systematic social devaluation to 'sub-human' because it also left me with AUTISM (diagnosed at 64yo after finally MRI ) >> denied jobs & a normal life, and ALL the above, plus repeated surgeries for neuro-inflammatory conditions, surgeries that could have been avoided if I had been treated. Miraculously I somehow managed a PhD in Ecology of Health, but still ended up in the dehumanising category 'unfortunate homeless' of rejects/defectives - for the past 10 years living in a car (with a very weakened post-menopausal body riddled with diagnosed "syndromes" & altogether a "complex syndrome" repeatedly supposed "psychiatric": they DID lock me up once, made threats, and coerced drugs into my veins that are deeply damaging to autonomic nervous system). And according to neurotypicals, I still wasn't working hard enough. Yet, I did 'manage my condition', learned to care for my physiology better than normal people, and have been proven repeatedly free of any psychiatric diagnoses, incl. ptsd for 35 years.
It turns out now that my original PhD work that helped me understand my life of many types of Crises and what happens at limits, caught the attention of the autism research community. I was not crazy-lazy as "they" told me all my life - but I STILL GET NO BRAIN CARE.

Please do create a CLINICAL SPECIALITY for
-TBI >might be 'mild' structurally, but functionally it is catastrophic at the highest order for life within society (for me not if living in nature though: many dysfunctions show only under man-made pressures)
-AUTONOMICS > affects EnErgo that family doctors interpret as 'mood' & 'psycho' & the ICD label 'Depression/Anxiety' pseudo-diagnosis ...given on no objective evidence! just when they can't be bothered investigating, label that is NOT in the DSM5 0 but it is a curse that lands me in psych ward when I am dehydrated, malnourished, anemic)
-and HYPOTHALAMUS (increase our knowledge and tests resources please); it governs basic physiolgical REGULATION of EVERYTHING, and is influenced by the autonomics (the other way around too - affects for example appetite & self-care: re. the movie 'concussion' at the beginning).
-lifelong, women (and some men) with a 'sensitive' brain are more affected than normal people; women's bodies cannot withstand as much intensity or timelength of autonomic activation as the male body: the effects are worse ; in men, the effects or difficulty in regulation tend to show more in ageing, or after worse TBI.
Please do expand your horizons IN PHYSIOLOGY, not just as a sad human story.Gather the information we need on these organs.

Could not agree with you more Brenda! Key points doctors and access... TBI’S are not a psychological problem they are an injury! Why are we rushed to the psych ward for this after a life of abuse and episodic injuries and there accumulative damage. We wouldn’t go to a shrink for broken bone, heart attack or other life threatening incident of which are catastrophic... so why then are we subjected to further damage from psychoactive drugs and not treated for the actual injury? My opinion is that of ignorance on the part of the medical community and the greed of big Farma yes FFFF as well as Pharma...that’s my rant take what you will from it! Neglected TBI and COMPLEX PTS [CAN WE PLEASE DROP THE DISORDER HERE] SUFFERER

Glad to see some attention going to the LONG TERM. I wish I had a stack of copies of this article. I would paper this town , especially the so-called hospital and then reach out to law makers. GIVE US SOME DOCTORS AND THE RIGHT TO ACCESS THEM! Thanks for speaking up!