Concussions & PTSD

Transcript from Webinar for Somatic Experiencing Trauma Instituteconcussions and PTSD symptoms August 8, 2014 By Dave Berger, MFT, PT, LCMHC, SEP, MA I’m going to lecture for about 15-20 minutes, then take questions. Toward the end I’ll present two cases that demonstrate very different presentations of concussions and treatment. Please bear with me as I read the lecture. The brain is a well-protected gelatinous-like vital organ that resides in fluid, three thin membranes and bone. Despite its multi level protective covering it is fragile and vulnerable to injury and shock. Injuries to the brain can lead to significant and life changing alterations in cognition, perception, motor function, learning, sensory awareness, pain, sleep and social interaction. It can also lead someone into a never-ending health care maze. We are going to take a brief look at minor injuries to the brain called concussions and how they overlap with PTSD. Major brain injuries resulting in death of large segments of brain areas are due to head trauma with or without a fractured skull and bleeding in the cranial vault (skull) but are beyond the scope of this webinar. We will focus on Mild traumatic brain injury (MTBI). MTBI constitutes 80% to 90% of traumatic brain injury (TBI) cases in the United States and are only recently being acknowledged as prevalent and damaging. From schools to the NFL and from the military to the White House concern about MTBI is finally getting recognition. This webinar will begin a discussion on trauma, concussions and what we as Somatic Experiencing Practitioners can do about them. A concussion, or minor traumatic brain injury is defined as a complex pathophysiological process affecting the brain and is induced by biomechanical forces (1). They result from any incident in which the brain is jostled and knocked around in the skull enough so the fluid padding, cerebrospinal fluid, that the brain floats in for both protection and nutrition is not enough to prevent it from hitting up against the inside of the harder skull. These include hits or blows to the head, loud sound waves, jolts to the spine and vibrational or impact forces. There are two significant injuries that result in a concussion—impact shock and structural damage. Impact shock: At least three physical impact events occur to the brain that result in mTBI: . The initial impact occurs with a boundary breach and a blow to the outside of the skull. This is followed by the brain hitting up against the inside of the skull at least twice, more if the brain bounces around several times and in multiple directions. (These are called cou and contra-cou lesions. Cou is the initial hit and contra-cou is the hit on the opposite side of the inside of the skull) These three physical injuries can result in multiple local/regional shock trauma/immobility to the areas of the brain that get hit. Structural...

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