I recently stumbled on a well-referenced article published in the Journal:Brain Pathology out of the University of Pennsylvania and the University of Glasgow dealing with head trauma/traumatic brain injury (TBI). No, this was not hot-off-the-press as some of my recent blogs, but from 2012.
What is interesting in this article is that it demonstrates that at autopsy the brains of those with only one incident of head trauma were demonstrating similar brain protein abnormalities as those seen in Chronic Traumatic Encephalopathy (CTE). This is the same disease discovered at autopsy of the brains of impaired NFL players.
Why is this important? Many studies already demonstrate cognitive impairment after a single, even mild, head trauma. Returning veterans have shown evidence of TBI after a single concussive event from an explosion.
I think it is important because we are all naturally skeptics. We don’t believe the evidence. I think the public accepts the fact that an NFL player who has repeatedly been struck about the head can have a damaged brain. But I have the sense there are many doubters when it comes to less severe injuries.
I think there is a widely help misconception that patients can fake cognitive tests even though neuropsychologists say that tests detect malingering. Well then here it is- it’s hard to fake an abnormal brain appearance under the microscope at autopsy. The brain tissue stained with abnormal proteins is on the slide.
And this same study demonstrates the disease appears to be progressive. Now this is a scary thought and begs for more research. Does acute brain injury lead to chronic inflammation of the brain, a common belief in neuroscience? My previous blog (Traumatic Brain Injury and Children) discussed recent success in detecting brain proteins leaking into the blood after head trauma. This will likely lead to a widely available blood test for head trauma patients in the next 2 years, the issue now is cost.
But there are many similar tests in the research pipeline. Hopefully, some of these tests will not only detect acute injury but chronic inflammation which corresponds to these damaged brains at autopsy. It’s hard to prevent head trauma, but medical science is getting better at recognizing and treating chronic inflammation.
Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as a Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.
