Understanding Traumatic Injury to the Human Brain

Collection Editors

Amy Markowitz, Robert Knight



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About this collection

Your noggin, your noodle, your coconut, your bean! There are many terms for your brain, that fantastic organ that sits inside of your skull, and runs, well, everything, whether you are thinking about it or not. Although the skull is a hard, purpose-built case to protect the brain, we live in an active environment, in which expected events and unexpected accidents may cause what we call a “traumatic brain injury” – everything from concussion on the sport field, to falls from a bike or a ladder or a snowboard, to car accidents and everything in between. These different mechanisms of injury may cause contusions or bruises to the brain, like a bruise to a muscle, and may also result in bleeds in or around the brain, called hemorrhages.

All of these types of brain injuries can result in damage to the actual brain tissue as well as cause interruptions to the complex electronic circuitry of the brain, causing symptoms like headaches, dizziness, fuzzy thinking, upset balance, memory loss, and poor sleep, to name just a few. Doctors are very good at treating the acute problems from a brain injury but we currently have no effective treatments for the actual injury to your brain and have to wait and see how the injury resolves on its own. While most people do recover spontaneously, for some, kids and adults alike, the symptoms can persist for a very long time, from months to years and sometimes permanently.

If there is any positive that can come from injuring the brain, it is that sometimes the only way to understand how something works is to “break” it, and watch how it puts itself back to together. In this collection of articles, we’ll study the way we diagnose where and how the brain has been injured, how we treat the acute injury and discuss new models to enhance recovery of brain function. The first steps in our roadmap require a careful assessment of the details of the person’s accident, examining the person thoroughly, and then reviewing special imaging studies called computed tomography (CT) or Magnetic Resonance Imaging (MRI) that show us the structures of the brain, and how they are connected or disconnected following the injury. New blood tests can identify the presence of special biomarkers that indicate that there has been an injury to the brain itself, rather than just to the bony skull. Other important information can come from electroencephalography (EEG), which uses small sensors attached to the skull to capture and measure electronic signals traveling around the brain, to see where the interruptions may be occurring.

We’ll learn about special surgeries, including hemicraniotomy, where the neurosurgeon “pops your top”, sometimes to relieve pressure on the brain, or to stop a hemorrhage from bleeding further, or to insert a protective metal plate. Surgeries and imaging studies give us a great deal of insight about the injured brain, but then what? Studies of other mammals, like rats and mice, can help us, but how, for instance, do we study a rat’s memory? We’ll find out how scientists accomplish this, and see how this knowledge might help patients recover memory after a brain injury.

Importantly, we’ll also learn how can we protect our brains from injury, even when we can’t avoid the accidents that come with everyday life. We’ll explore emerging design of sports helmets and other gear, and learn how a strong neck and back can help prevent injury to the brain and spinal cord.

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