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Head Injury Causing Psychiatric Symptoms,
How to Treat   

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The following comments were taken from health professionals exchanging information on treatment of head injuries on Safe Harbor's Integrative Psychiatry e-mail list:

From Safe Harbor:

Here is an article we ran on head injury in one of our first newsletters:

The rate of psychiatric illness one year after a traumatic brain injury is significantly greater than that of the general population, reported the American Journal of Psychiatry, March 1999.

A sharp increase was observed in the rate of occurrence of depression. It was nearly seven times higher in the brain injury group (13.9% of the 196 adult traumatic brain injury patients studied, compared with 2.1% of the general population).

Panic disorder was more than 11 times more prevalent in the head-injury group (9.0%, compared with 0.8% of the general population).

Dr. Shoumitro Deb et al., authors of the article, stated that neurobehavioral symptoms are not uncommon after a traumatic brain injury. However, psychiatric syndromes per se have rarely been studied in patients with such injuries.

The study confirms the work of a growing number of physicians who now ask about prior head injuries as a standard procedure with any patients complaining of severe mental symptoms.


From Clancy McKenzie, M.D.:

Postconcussional Disorder was hardly recognized in the psychiatric world and still goes unnoticed. It is even less recognized by neurologists, because usually there are only soft signs and even though the person can be severely compromised, this does not appear on CT, MRI, or gross neurological examination. It takes neuropsychological testing, digital computerized EEG with evoked potentials, careful neuropsychiatric evaluation, or PET scans to demonstrate change in brain function.  

I look for blurred vision, double vision, traumatic glaucoma, tinnitus, vertigo, hearing loss, loss of sense of taste or smell, absentmindedness, head pain, drop attacks, partial complex seizures (which usually are overlooked), reversing of numbers, letters, and left versus right, poor concentration, attention, and memory, along with sleep disturbance (sometimes persons require an additional ten hours sleep, for example). The duration of loss of consciousness is not necessarily critical.

Many persons have had gunshot wounds to the head without losing consciousness. The duration of dysconsciousness is important, even if there never were a loss of consciousness.  Swelling that is not reduced early can lead to later contraction and normal pressure hydrocephalus – noted by the triad of apraxic gait, bladder urgency and difficult cognition.

Hyperbaric oxygen is a good first choice if available – or ozone can be even better if properly administered. Even straight oxygen will reduce swelling if used long enough. Many persons recover without serious sequellae, but more often than not the sequellae simply are not identified as being a result of the head injury.  

Another thing that has not been mentioned here is the use of parenteral hydroxo or methyl cobalamine. Most neurotoxins contain the cyano attachment, which binds very tightly with cobalamine (Vitamin B-12) and then is eliminated. I don’t recall the reference, but one neuropsychiatrist gave injections of methyl or hydroxocobalamine in increasing doses, up to 25,000 mcg, until symptoms cleared, and objective psychological testing demonstrated change

A CT scan would show bleeding, if that hasn't been done. The hyperbaric oxygen reduces swelling very fast. Even breathing oxygen outside a pressure chamber is effective but takes longer. Ozone would be great (but not to breathe) and if you know anyone in integrative medicine in your area who knows how to administer it and is willing, that is what I would do. (In many states ozone treatment is not allowed.)

Post concussional disorder (PCD) can have lasting sequellae (after-effects of an injury), so it important to get treatment to reduce swelling as soon as possible. The bleeding causes release of iron from hemoglobin, which leads to the Fenton reaction that produces free hydroxyl radicals that attack the cell membrane and then result in 4- hydroxynonenal which is a neurotoxin. This can result in an ongoing process.

Often people do not recognize PCD as a cause of irritability, depression, absentmindedness - and they wonder what is wrong. She should be made aware of what is causing it, and also that usually it is temporary. In light of the lack of coordination I would definitely get a CT scan which would show any bleeding. 


From Dr. Ted Cole, D.O., N.M.D.:

The best is Hyperbaric Oxygen Therapy, second is Neural Therapy. 
These can usually reverse the problems in 1-3 days.


From William Walsh, Ph.D.

I have met many persons who are in prison because of behavior changes following a head injury. A prime example is Bobby Joe Long who became a different person after a motorcycle crash, and now is on Florida's death row for murdering eight persons. I've tested his chemistry, and it is quite normal. I believe that approximately 5 percent of prison residents are incarcerated because of behavioral changes after a head injury. 

Many years ago, the great Carl Pfeiffer told me that head injury patients often respond well to supplements of octacosanol (2,000 to 4,000 micrograms daily), taken together with zinc, B-6, and Vitamin C. He said that it helped repair damage to myelin sheaths in the brain. I've used this many times over the years with apparent excellent success, based on anecdotal case histories (which of course have limited scientific value). 

A few years ago, we collaborated with a doctor from the Schwab Rehabilitation Hospital which specializes in head and spinal injuries. We provided the above nutritional supplements to about a dozen persons with severe brain injuries. About 2/3 of them reported very nice improvements. One man who had been on a plateau after 2 years of Schwab's physical therapies was able to walk again after 3 months of octacosanol, etc. Another head injury client with aphasia was able to talk coherently after a few months.


From Luis F M Campos, M.D.:

Concussion, traumatic brain injury & post-traumatic caphalea (headaches) unhappily are far more common than we can imagine. I suggest:

Immediately 
1 - Give a lot of green tea, vitamins C & E in megadoses (2400 UI vit E/day and 3 g/day Vit C) + Resveratrol (a natural remedy) + Lipoic Acid 600 mg/ day + Coenzyme Q 100 mg/ day (antioxidants) 
2 - Corticostesteroids (betametasone 5 mg/ injectable) /day (3 days) + Vitamins B1 and B12 (injectables) in high dosages 
3 - Pentoxyfiline [a medication for blood circulation] (injectable in the first 3 days) 
4 - Magnesium injectable (best) or oral (orotate) 500 mg/day of elemental magnesium 
4 - MRI Brain & Skull 
5 - Search for a good neurologist 
6 - Access sites National Neurotrauma Society http://www.edc.gsph.pitt.edu/neurotrauma/ 


From Walter Lemmo, N.D.

While the medical work up is being performed, don't forget about using good vitamin c. Lower plasma levels of vitamin c has been correlated with more serious brain traumas: most like related to increased oxidative stresses. At the very least, the oral use of vitamin c should be implemented, however, the intravenous application would be most ideal, very easy, and safe to perform. Short IV boosters using 2000-5000mg 2-3 times per week would most likely suffice followed by continued oral dosing.


From Kit Humphrey, M.D.:

In addition to the noted vitamin C,E, fatty acids, alpha lipoic acid, magnesium, Milk thistle has been shown to have neuroprotective benefits. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12059045&dopt=Abstract 


From Michael Wood, D.C.

After ruling out haemorrhage consider having a chiro check her spine. Trauma of that nature to the cervical spine can cause persistent symptoms such as you describe. 


Gary Erkfritz, D.C

One of the things I've found highly successful in situations such as this is using a Bach Remedy called "Rescue Remedy". You can find them at almost every health food store. Bach remedies are made from flower essences. 

Another thing I've found successful is a product called "Traumeel" by the Heel Company. They are a German homeopathic company with US Distribution offices in Albuquerque. Many times you can find this product at health food stores as well.

Arnica montana (an herb and a homeopathic remedy) might be of some value, although after four days I would think not. Perhaps something for the medicine cabinet for "next time".

And, oh yes, you might consider getting some cranio-sacral care for her as well. You can go to www.upledger.com for a list of cranio-sacral people - perhaps in your area.