Can concussion injure the lining of blood vessels in the brain? Yes. Recent studies show that trauma to the brain can damage the lining of the blood vessels and make them leaky. Usually, the content of the blood cannot reach inside the brain because the blood vessels in the brain have three protective layers; this is called the Blood Brain Barrier. With TBI, it appears that the BBB becomes leaky so that molecules that do not belong to the inside milieu of the brain enter this protected environment and damage the brain cells.
This is similar to the way when your sink pipe breaks the water floods your carpets and wood floors. Also, some of the content of the brain leaks out into the blood flow, and we can actually use this process to measure if someone has had significant TBI. All of these happen in parallel to the direct damage that a concussion poses on the extensions of the neurons and causing small tears in them. These “micro-tears” cannot be seen on MRIs but cause severe symptoms in patients, such as not being able to think straight, being slow in processing information, and feeling sad or tired.
Effective treatment of patients with a concussion should include interventions that would reduce leakage of blood into the brain and repair of the tears in neuronal extensions (axons). There are no specific medications to address these issues.
So, at this time, the best interventions include taking omega-3 fatty acids to protect the lining of the blood vessels and repair the tears in axons, to perform brain exercises that would help grow neurons and their extensions, to exercise in order to improve blood flow to the brain, and to do neurofeedback in order to harmonize and optimize brain waves and neuronal pathways.
These non-pharmaceutical interventions appear to be working well for our patients with concussion. More than 80% of them gain significant recovery of their symptoms.