Brain Health,
Sci + Society,

#152: Traumatic Injuries and Your Brain

October 28, 2016

There’s a lot of misinformation about traumatic brain injuries (TBIs).  One extreme example: people who go see their doctors about a possible concussion after a regular bump to the head, like hitting their heads on a low ceiling.

The good news, according to Dr. Kathleen Bell, Professor and Chair of the Department of Physical Medicine and Rehabilitation at the University of Texas, is that the majority of people who suffer mild TBIs will recover.

Episode 152 is a real treat, with not one, but two experts.  Dr. Martin Monti, Professor of Psychology and Neuroscience at UCLA, and Dr. Bell talk to us about the nature of traumatic brain injuries, when it’s a “no-brainer” to go see a doctor, and how to create a brain resilient to injury.

What Counts as a Traumatic Brain Injury?

At its most basic, a traumatic brain injury is any injury caused by an external force to the brain.  TBIs can range from minor to life-changing.

You don’t need to freak out about minor injuries, like banging your head on kitchen cabinets or a low ceiling.  Our brains are perfectly capable of repairing themselves after routine, minor injuries.

That said, if you’ve taken a blow to your head, you don’t want to ignore it (check the symptoms in the section below for more on when to go see a doctor).

The Risks of Traumatic Brain Injuries

With brain injuries, there are two types of damage you need to worry about:  primary and secondary.  Primary damage is caused by the original impact, i.e. where you knocked your noggin.  Secondary damage is caused by your brain swelling in response to the impact.

Getting a rush of blood to the brain after an injury should be good news for healing, but your brain is constrained by a little something called your skull.  Your brain pushing against your skill causes even more damage, which is why in severe cases doctors have to actually cut a hole in the skull to relieve pressure.

Besides the force of impact and level of swelling, being deprived of oxygen for any length of time is correlated to worse outcomes for patients.  When the brain is deprived of oxygen, deep parts of the brain, like the thalamus, are affected.  This is probably why people who experience oxygen-deprivation are less likely to regain consciousness and recover than those who only experienced trauma to the cortex.

Interesting, the demographic with the highest incidence of TBI is men between the ages of 15 – 25, generally caused by car crashes and contact sports.  The two other highest risk demographics are young children and elderly folks over 70.  Both are most likely to be injured by a fall.

TBI fun fact

Obviously, you don’t want a TBI.  But, it’s not all bad news.  Dr. Bell has seen patients who actually had positive personality changes after a TBI, including being more cheerful, more patient, and more artistic.

Editor’s note:  For legal reasons, we cannot recommend hitting yourself in the head in order to become a freakishly cheerful artistic genius.

When to Go See a Doctor ASAP

So you’ve taken a serious hit to the head (ouch!), now what?  Get ye to a doctor as soon as possible if:

  • You lose consciousness.  Most people who have a severe brain injury lose consciousness and may enter a coma.
  • You’re confused, can’t remember things, or are acting “off.”  The person with the TBI may not notice these symptoms, but the people around them will.
  • Your perception changes.  You may see stars or wavy lines or have other abrupt changes to your vision.  Your hearing can be affected too.
  • You have a headache that gets worse or doesn’t get better after taking pain medication.
  • You feel nauseous or have problems balancing.  A TBI can affect your inner ear or neurotransmitters, damaging your balance and making you feel car sick even though you’re not moving.
  • This is the second hit to the head you’ve sustained recently.  This is especially important for children.  If children have two concussions around the same time, they are much more likely to have a very bad outcome.  There’s no clear “safe period” long between TBIs.  The danger period clearly covers when the person is still symptomatic, but even after they seem recovered, the brain may not have returned to normal functioning.

How to Build an Injury-Resistant Brain

If you crack your head open falling off your bike because you weren’t wearing a helmet, there’s not much you can do.  But you can help your brain be prepared to weather traumatic injuries by doing the following:

  • Don’t smoke.  As if you needed another reason to avoid tobacco:  smoking decreases blood flow — essential for healing — to the brain.
  • Eat brain healthy foods.  We’re not talking about the latest fads in “superfoods” here, but about a balanced diet high in whole foods, and particularly Omega-3s.
  • Exercise regularly.  A single session of exercising improves cognitive abilities immediately.  Regularly exercising helps your brain build a strong web of neuronal connections, making it easier for it to sustain damage to some neurons.
  • Don’t use drugs or alcohol frequently.  An overuse of drugs or alcohol can alter your brain chemistry, negatively impacting your ability to recover from brain injuries.

PS:  Learn more ways to have the healthiest brain possible with our weekly Brain Breakfast.


  1. Ben says:

    Great article. Do you have any specific recommendations about nutraceuticals or nootropics that might facilitate recovery from traumatic brain injuries? I remember reading that if you’ve had one TBI, you’re more likely to have another one. Any ideas why? I was thinking maybe the cause is genetic clumsiness.

  2. Debbie Berry says:

    Do you have any information on brain shear suffered during a tbi, and it’s affect on exercising good judgement?

    1. Jesse Lawler says:

      Hi Debbie – Maybe check out this link. “Brain shear” wasn’t something we really touched on in our discussion, so this definitely would merit further research.

  3. ben says:

    Dr. George Brooks has interesting research about how giving lactic acid to someone who has suffered a traumatic brain injury, can minimize the injury. The theory goes that lactate easily crosses the blood brain barrier to provide energy, which is important since glycolysis is impaired during TBI. See Rhonda Patrick’s interview with him around the 25min mark.. they didn’t mention it, but I imagine taking exogenous ketones, like mct oil, might also work for same reason.

    Regarding how coma helps healing, Radiolab’s episode ‘Rodney Versus Death’ talks about how inducing coma can save someone from the rabies virus, which is typically 100% fatal. Apparently, unlike other viruses that spread thru the bloodstream, rabies binds itself to a nerve at the puncture wound and slowly crawls up to the brain (1-2cm/day) which then causes the brain to go haywire. However, by inducing coma you buy time for the immune system to kill it without the disruption of a brain out of control!

    (BTW, I’d also recommend the ‘Unraveling Bolero’ episode and the Oliver Sack’s Ted talk for the strange ways our brains react to damage!)

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