Dr. Diane Stoler is a neuropsychologist and sports psychologist and a traumatic brain injury survivor. She suffered a stroke while driving and then crashed her car at high speed. Dr. Stoler is also the author of Coping with Concussion and Mild Traumatic Brain Injury. She spoke with Now! host David Byrd about the subject.
BYRD: First of all, what is a brain injury, whether it is traumatic or a concussion, or otherwise, what constitutes the medical definition of a brain injury?
STOLER: Brain injury has two subdivisions. One is acquired and one is traumatic. Acquired would be something like a stroke. A traumatic injury is anything that is from an outside force. So if it’s a gunshot wound, hitting an object, anything from the outside versus the inside which would be MS, Parkinson’s, so that’s what’s called an acquired. Those two categories fall under of brain injury.
BYRD: And what are some of the symptoms that people with brain injury will manifest typically?
STOLER: Typically they will have sensitivity to light. The most common is the headaches, fatigue, they have like a brain fog. Their mood can change. They become very edgy. They as I said, their skin can be more sensitive. But for most of them, it’s the sleep disturbances. The headaches are the ones that most people complain about.
BYRD: And what are some of the steps that are the road to recovery for people? Obviously that depends on the severity of the injury. A lot of veterans coming back from Iraq, Afghanistan have had traumatic brain injuries because of explosive concussion. Something like that is going to take an awful lot longer than say someone falling off a bike maybe.
STOLER: Well there’s three categories if we want to talk about traumatic brain injury and they are based on the duration of time someone has been unconscious and having some form of amnesia or memory loss, either anterograde or retrograde. And so the first is barely dazed to one hour, that is called a concussion. If it’s an hour to 24 hours, it’s a moderate. If it’s between after 24 hours, it’s called in a coma. So when you saying he’s six months in a coma, that’s considered a severe traumatic brain injury. All three traumatic brain injuries all form dysregulation of neural circuitry in the brain. But how long is someone unconscious.
BYRD: Now you’ve had some personal experience with this as well. You suffered both a stroke and that led to a head on automobile collision, what was your recovery process like?
STOLER: Well one of the things, when there has been a brain injury that has been followed in a relatively short period of time with another injury, that’s called “second impact syndrome”. So is that, I had the stroke, passed out while driving. Had a 60 mile per hour head on and then five months later I had brain surgery and had a portion of my brain removed. So those three subsequent brain injuries, I mean, brain surgery is considered a brain injury, is that’s the second impact syndrome? And then the symptoms, the dysregulation, the swelling of the brain is now not, the symptoms are not arithmetic, it’s geometric. And so it’s not one plus one, it’s one plus three. So once you have this dysregulation in the brain and the swelling has increased. So that is what happens. So when you have repeated hits like in soccer or in football and it’s not treated and the brain does not—Then you’re starting to see what you see in CTE which is Chronic Traumatic Encephalopathy. Where now the actual protein comes out which is called tau, comes out and eats the brain away. That’s the extreme. In my situation it took me seven years to learn walk, talk, and recover,
BYRD: What are some of the things people can do if they have suffered from a head injury of any time? Is there anything to look for as far as symptoms? And when is it time to go see the doctor?
STOLER: If you had a concussion you go to the doc. That’s the first thing I would tell you. And then depending on if you’re in any kind of situation that there is a need for proof, such as in an auto accident at work or in a situation that someone may have a legal case, you must go to the hospital. You must get at least an MRI. And if you’re going to get an MRI you should get an SWI, which is single weighted. And a DTI and a cat scan will show if there is a bleed or not. But they do not show the microscopic tears that a SWI or DTI show. That’s the first.
And then the second is that you need to rest. Your brain needs to recover. You need to go and drink a lot of water. You also need to eliminate sugar and you want to increase proteins and omega 3’s. I would recommend, anybody can go online and they can get an anti-inflammatory diet, cause the brain like I said before is swelling so you want to get something that reduces the swelling like omega 3’s. You want to eliminate omega 6’s that are in beef. You want to rest, you want good nutrition and you know getting to the doctor and a lot of sleep, as much as you can so the brain can start getting back regulation. Now if the symptoms last beyond six months. Then is when, what I what I address in my book, is post-concussion syndrome. That’s PCS. And then is the different methods for the specific symptoms you’re having, from your headaches to other areas.
BYRD: Now that’s been mentioned recently in the settlement that the National Football League made with several of its players. Players went on to develop things like Parkinson’s and other traumatic brain injury diseases for lack of a better way of putting it. How do you counsel people to handle the emotional changes that go with a traumatic brain injury?
STOLER: I have a whole chapter on this. I also go around giving presentations on this. It’s grieving a loss for self. You go from being active 20 year old, 30 year old. Whatever your age is, all this and now you’ve been catapulted to this 90 year old who cannot remember what your name is. I don’t know how many people remember the movie fifty first dates but I was like ten minute tom, If I turned my head and looked back at you, I would say hi my name is and I would turn around and you would be a new person. So short term memory was really gone with me so it’s-- That is devastating if you’re active or were active and can’t remember things. I didn’t remember schedules; I had to pick up children. It’s grieving the loss of self. That person who you were may never come back. You may regain many skills but you may never regain depending on the severity, depending on the regulation. So the quicker you can start to address the dysregulation of the brain. Also what helps is neural feedback. That is specifically designed to help the brain like physical therapy is to our muscles, is neural feedback is to helping to get the dysregulated brain back into being a regular functioning.
BYRD: How important is the support of family and how does a family cope with traumatic brain injury or post-concussion syndrome?
STOLER: It’s very important. The brain injury association in the United States and in every state, and province, has a brain injury association. They have it in Canada, they have it in England, they have it all over the world. There are brain injury associations, they have it somewhere down in DC and in Delaware, every state. So it’s important, there are support groups. To find one talk to other people so you can get support. Because again, depending on the severity, depending on whether the person has personality change. If the person becomes more irritable and finding the resources and also knowing that my books are out there to help the family. There are chapters in there devoted completely to the family. Because not only, I joke with people that I am the club president, I’m a client. I was a caregiver. My mother had a concussion and a stroke. My son had three concussions and I ended up being the caregiver and they did not who they were for a while.
BYRD: Alright that is Doctor Diane Stoler. She is a neuro-psychologist and a sports psychologist. She’s also the author of coping with concussion and mild brain injury. Dr. Stoler thank you so much
STOLER: Thank you.
To learn more about traumatic brain injury, please visit the U.S. Centers for Disease Control and Prevention website or visit The National Institute of Neurological Disorders and Stroke.