Concussion And Your Vision
Head trauma and concussions can have major effects on the visual system even when medical imaging shows normal results. The group of symptoms that cause blurred vision, eye coordination issues and dizziness after a concussion is collectively called post-trauma vision syndrome.
The main symptoms that occur in post-trauma vision syndrome are:
- Dizziness
- Headaches
- Double vision
It seems that people who have more severe post-trauma vision syndrome symptoms are often people who have some type of previous eye-teaming issues. These people tend to have much more difficulty with reading and eye-tracking after a concussion.
Even mild concussions can affect vision and cause visual dysfunction. Severe concussions can cause blindness and double vision.
More subtle effects on vision are difficulty focusing on near objects or on digital devices after a concussion.
Cognitive Function In Relation To Fatigue
From the book by Lezak et al., p 177 , the effort to accomplish ordinary activities after a brain injury is exemplified.
Activities that are normally automatic but become effortful after the injury include many that are performed frequently throughout a normal day, such as concentrating, warding off distractions, reading for meaning, doing mental calculations, monitoring ongoing performance, planning the days activities, attending to conversations at once, or conversing with background noise, etc. It is by little wonder that by late afternoon, if not by noon, many of these patients are exhausted.
What Does Brain Fog Feel Like And When Does It Happen
Brain fog is one of the most common symptoms we see in patients who come to us for post-concussion syndrome treatment. Here are a few ways theyve described the experience:
- Its like Im seeing the world through a haze.
- I just cant process everything.
- I feel like my thinking is slower than it used to be.
- I cant keep up.
- Its like theres molasses in my brain.
- I feel like Im running in sand.
Brain fog most commonly happens when youre putting more demands on your brain. It can happen in social situations, such as when youre trying to have a conversation and theres a lot of noise and activity around you.
Tasks like reading, using the computer, or even just being in a visually busy environment are common triggers for brain fog because those tasks involve about 50-80% of our brains. Being in pain also might result in foggy thinking.
Why? What causes post-concussion brain fog? The simple answer is that key areas of the brain arent functioning efficiently anymore. It feels like your brain is slower because it is slower. Its using workarounds and draining resources to do things that used to be easy.
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How To Treat A Concussion
What are the best ways to treat a concussion? And how long does it take to recover from a concussion?
While concussion recovery time can vary dramatically based on how severe the injury is, 80% of concussion victims will generally recover between one and two weeks after the injury. If you have concerns due to prolonged recovery time, speak with your primary doctor.
Treatment plans vary depending on the patient, symptoms, and severity of the concussion. In general, the doctor will give concussion victims a plan for recovery that will expedite healing.
Why Fatigue Is So Common After A Head Injury
Head injuries can lead to a variety of symptoms, but one of the most common symptoms that often goes overlooked is the feeling of fatigue. Recovering from a traumatic brain injury can be both physically and mentally draining, and that can leave you feeling more fatigued than normal. In todays blog, we take a closer look at why fatigue is a common complication after head injuries, and how to best treat the problem so you can get back to a normal life.
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Risks Associated With Post
Fatigue after brain injury can significantly affect an individuals quality of life. For example, it can discourage physical activity, self-care, and socialization. It not only makes it tiresome to participate in everyday activities but can also affect your motivation.
As a result, fatigue can discourage individuals with traumatic brain injuries from pursuing rehabilitation. Many functions affected by brain injury can be relearned and improved because the brain has neuroplasticity. Neuroplasticity refers to the brains ability to make adaptive changes and rewire its neural circuitry. The most effective way to promote it is through highly repetitive and specific practice.
However, constantly practicing the same exercises over and over again can be extremely challenging for individuals with fatigue. As a result, fatigue can make it difficult to stay motivated and practice the repetitions you need to improve.
In the following section, well discuss various ways individuals can reduce fatigue after brain injury to improve their quality of life.
Brain Fog And Depression
Its very common for patients to come to our clinic with a depression diagnosis. Weve found that about 82% of the patients who come to us for post-concussion syndrome treatment list depression, anxiety, and personality changes as their main symptoms.
Why is that?
For one thing, post-concussion syndrome and depression symptoms often overlap. It can be difficult for general practitioners to differentiate between them. The conditions might coexist independently of each other, but changes in the brain due to a concussion can actually cause depression.
Research shows that problems in the thalamus and hippocampus can lead to depression. The thalamus helps process sensory information, which can affect our feelings and behavioral reactions.
The hippocampus attaches emotional components to memories and can be affected by stress hormones. The prefrontal cortex also helps regulate emotions, so if this area is experiencing concussion-related problems, it can contribute to depression.
In addition, life is just harder after a concussion. People are often in pain. They might have to restrict their activities. Even normal activities like going out to lunch or to a movie might suddenly be intolerable. They often disconnect from their social networks and become isolated. Drastic lifestyle changes like this can certainly lead to situational depression.
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What Is A Concussion
During the impact of an accident, the brain bounces back and forth inside the skull. This can cause bruising, bleeding, and tearing . Immediately after the accident, the person may be confused, not remember what happened or have nausea, blurry vision, or dizziness. The person may appear fine at first but show symptoms hours or days later. One does not have to lose consciousness to suffer a concussion.
Concussions are graded by severity:
Grade I: no loss of consciousness amnesia is absent or present for less than 30 minutes.
Grade II: loss of consciousness for less than five minutes or amnesia for between 30 minutes and 24 hours.
Grade III: loss of consciousness for more than five minutes or amnesia for more than 24 hours.
Go to an emergency room if you or someone with you has suffered a head injury and has lost consciousness, is vomiting, having seizures, or having obvious difficulty with mental function or physical coordination.
If left undiagnosed, a concussion may place a person at risk of developing second-impact syndrome, a potentially fatal injury that occurs when an athlete sustains a second head injury before a previous head injury has healed.
Thrombosis And Microclots In The Lungs
As well as causing severe respiratory problems, COVID-19 also seems to trigger abnormalities in blood clotting. Studies show that as many as 30% of critically ill patients develop blood clots in veins and arteries, increasing the risk of heart attacks and strokes. If a blood vessel carrying blood to or from the lungs is blocked by a clot, it can cause sudden and intense breathing problems.
Typically, these clots are bigger than 1mm in size and can be detected by a CT scan. However, healthcare providers are becoming increasingly aware that smaller clots named microclots can be just as dangerous and virtually impossible to see. If these microclots start to develop in the capillaries in the lung, they may block gas exchange, ultimately leading to shortness of breath.
Doctors are concerned that standard blood-thinning medication to prevent these clots doesn’t seem to work in COVID-19 patients. Some hospitals are giving patients much higher doses than normal, and clinical trials testing different doses of blood thinners are currently underway.
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Types Of Fatigue That Can Occur After Brain Injury
Everyone experiences the effects of TBI differently. Fatigue may be more severe for some than for others however, fatigue is not correlated to the severity of TBI. In other words, fatigue is just as common in individuals with mild TBIs as in those with severe TBIs.
Its important to understand what type of fatigue youre experiencing to target your specific symptoms and effectively treat them.
There are 3 primary types of fatigue that an individual may experience after brain injury:
The type of fatigue you experience after a brain injury will primarily depend on which areas of the brain are affected as well as the types of secondary complications you experience. While it is possible to experience all three types of fatigue after brain injury, most individuals experience cognitive fatigue.
Brain Fog And Vision Problems
Common vision problems our patients report are blurry vision, difficulty focusing or reading, light sensitivity, and problems with peripheral vision, among others. Patients might not experience these problems all the time. They might only notice them after trying to use a computer or after reading for awhile, for example.
Vision tasks require a huge amount of brain function, and if any of the areas of the brain that are involved in that process arent functioning correctly, the brains energy is going to be rapidly depleted. These problems can also induce other post-concussion symptoms such as dizziness, feelings of overwhelm, and headaches.
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Get In Touch With A Brain Injury Attorney Today
If you need the help of a qualified attorney that has experience helping victims of concussions, get in touch with Brain Injury Law of Seattle today.
Our founder and lead attorney, Scott Blair, has 25 years of experience working in brain injury law and TBI cases, and hed be happy to assist you during this difficult time.
Brain injury cases are some of the most complicated, stressful, time-consuming legal situations a victim can face. Rather than take on this battle on your own, get the legal backup and support you need to make this time more manageable.
Head Injury Prevention Tips
Buy and use helmets or protective headgear approved by the American Society for Testing and Materials for specific sports 100% of the time. The ASTM has vigorous standards for testing helmets for many sports helmets approved by the ASTM bear a sticker stating this. Helmets and headgear come in many sizes and styles, and must properly fit to provide maximum protection against head injuries. In addition to other safety apparel or gear, helmets or headgear should be worn at all times for:
- Baseball and softball
- Cycling
Headgear is recommended by many sports safety experts for:
- Soccer
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What Can I Do To Help Myself Get Better
Fatigue after a mild head injury gets better by itself over time. However, there are a few things you can do to help this recovery.
1. Instead of avoiding usual activities, try to gradually get back to your normal routine.
People who are worried that they have sustained serious damage sometimes avoid usual activities. This does not help them to recover, but in fact can lead to loss of confidence and physical fitness and so makes fatigue worse. It is important to remember that the symptoms of mild head injury improve over time and do not cause longstanding problems or future dementia. Getting back to usual activities will help fatigue to gradually improve.
2. Dont do too much at once. Be realistic and gradually increase activities.
However, doing too much in a single day, to start with, might make you feel very tired indeed, maybe even so much so that you dont feel up to much the next day. If you are someone who is used to being busy and active, getting a lot done, it is easy to get into an unhelpful cycle of busy days with days in between where you feel totally exhausted. When you are in this pattern it can be difficult to make any forward progress and can feel like you are back to square one a lot of the time. This pattern is more likely to happen if you dwell on all or nothing thoughts, like If I cant get back to working a whole day and then running five miles, Im not going to do anything at all.
3. Improve fatigue by improving your physical fitness.
Breathing Techniques To Do At Home
Unlike digestion or blood pressure, breathing is an unusual body function in that it is both involuntary and voluntary. Most of the time, we breathe without thinking about it, but at any point, we can consciously change our breathing pattern.
There are several breathing techniques that can help restore diaphragmatic breathing and increase lung capacity. These exercises also lessen feelings of anxiety and stress, which are common in Long COVID patients. These activities can be done anywhere and are easily incorporated into a daily routine.
Just remember that these exercises are not a replacement for medical advice or medical attention, especially if you are having severe symptoms.
Relaxed, slow, deep breathing: This is a quick technique you can easily perform anywhere. Find a comfortable position and relax your shoulders. Then, gently breathe in through your nose, and breathe out through your mouth. Repeat as many times as needed.
Deep breathing: The idea behind this exercise is to maximize the amount of oxygen entering the body and the amount of carbon dioxide leaving. It includes three parts: start by inhaling deeply through the nose while counting to 5 hold your breath briefly and finish by exhaling through your mouth longer than the inhalation. This activates the parasympathetic nervous system and counteracts the sympathetic nervous systems fight or flight response .
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Fatigue After Brain Injury: Getting Tired Of Being So Tired
My 28-year-old son was seriously injured in a car accident two years ago and suffered a critical brain injury. He can’t walk and is still unable to straighten his legs. What seems to bother him more than anything is how utterly exhausted he is all the time. He was always such an energetic young man and finds the exhaustion terribly frustrating because it prevents him from working as hard as he would like to in physical therapy. How long will the extreme bouts of exhaustion last?
Fatigue is a common problem after brain injury. Estimates of the incidence of fatigue for individuals with TBI range from 50-80 percent. Depression, pain, sleep disturbance, and neuroendocrine abnormalities all have been associated with fatigue after TBI.
You should talk to your sons physician about this problem so a careful evaluation can be done. Many of the medications that are used to treat spasticity, seizures, and mood can cause fatigue or sleepiness. Sleep disorders are seen in about 30 percent of people TBI even years after injury. In some cases, an overnight sleep study allows you to get a proper diagnosis and decide on treatment. Endocrine problems are becoming increasingly recognized as a cause of fatigue. Low thyroid, low adrenalin, low testosterone, and low growth hormone can all contribute to fatigue. There is a lot of current research being conducted on low growth hormone and how to best assess and treat this increasingly recognized problem.
Causes Of Fatigue After Brain Injury
Fatigue is one of the most long-lasting and common effects of brain injury. In fact, up to 73% of individuals report fatigue up to 5 years after sustaining their injury.
Various factors can contribute to increased fatigue after TBI. One reason fatigue is so prevalent is because in the early phases following a TBI, the brain focuses most of its energy on healing. While this is essential for stabilizing the brain after injury, it also leaves less energy to be devoted to other tasks.
Another explanation is the coping hypothesis, which suggests that individuals are more likely to experience fatigue after brain injury because the brain must work harder to compensate for impaired functions.
Moreover, feelings of fatigue may not be directly related to brain injury at all. Instead, they can stem from secondary effects of TBI, such as depression, pain, poor-quality sleep, and endocrine dysfunction.
In the following section, well discuss different types of fatigue that an individual may experience after brain injury.
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Brain Fog And Memory Loss
Dysfunction in several key areas of the brain can cause memory problems and brain fog.
- The prefrontal cortex processes working memory. It can only hold a few pieces of information at a time for about one minute. The hippocampus needs to file that information away in long-term memory to keep it. If the brain doesnt have enough energy , it cant send those short-term memories to storage. That means youre only going to remember something for 60 seconds or so, and then your brain will delete it.
- The thalamus collects, screens, and relays sensory information to other parts of the brain. If the thalamus isnt working properly, your brain isnt screening out the unimportant information. Its working hard trying to remember everything it sees, hears, and senses, and it just cant do that. Additionally, recent research indicates that the thalamus also plays a role in learning and short-term memory transfer.
- The basal ganglia helps us plan, process, and coordinate physical movement. Normally, we can simultaneously do things and remember things. However, if the basal ganglia isnt working properly, it draws a lot of energy from other parts of the brain just to maintain our many physical movements. It also means that its much more difficult to physically do something and remember things at the same time.
