View Full Version : Head injuries discussion


cameron90
02-01-12, 01:32 AM
I've seen a few posts about the relationship between head injuries and ADHD, as well as other disorders or mental illnesses. Questions about if ADHD can be acquired, how events pre- and post-natal can affect the occurrence of ADHD, and the brain/mind fascinate me in general. From a bit a research, it seems that there are more than a few instances where a minor head trauma can induce severe personality changes and abnormal/atypical thinking and behaviour. This is a topic that is of great interest to me because it was with a traumatic brain injury 8 years ago that my depression and anxiety emerged, seemingly out of nowhere. Now I am trying to figure out if that event has anything to do with the severity of my ADHD now, but I believe that is impossible to really understand.

I want to start a thread about head injuries: minor concussions to major brain injuries, anything involving bumping your head, losing consciousness from a bump to the head or anything related to this subject or ADHD / mental illness.

Prior to my traumatic brain injury about 8 years ago, I don't think that I had any type of head injury that was significant (i.e., resulting in loss of consciousness), but I do know that I fell down the stairs A LOT as a child, and most likely bumped my head more than a few times.

Fuzzy12
02-01-12, 02:10 PM
From what I've ready, it seems likely that ADHD is caused by physical abberations in the brain. I mean, there are tangible, measurable differences in the brain of someone with ADHD and the non ADHD brain (though I don't remember exactly what they are). So I can imagine that ADHD can be caused by trauma to the brain.


Prior to my traumatic brain injury about 8 years ago, I don't think that I had any type of head injury that was significant (i.e., resulting in loss of consciousness), but I do know that I fell down the stairs A LOT as a child, and most likely bumped my head more than a few times


I don't have any experience (or knowledge) of this and I'm also not saying that this is the case with you but I was just wondering if it is possible that people with ADHD are more accident prone?

namazu
02-01-12, 02:19 PM
I've seen a few posts about the relationship between head injuries and ADHD, as well as other disorders or mental illnesses. Questions about if ADHD can be acquired, how events pre- and post-natal can affect the occurrence of ADHD, and the brain/mind fascinate me in general. From a bit a research, it seems that there are more than a few instances where a minor head trauma can induce severe personality changes and abnormal/atypical thinking and behaviour.
Quick note 'cause I have to run, but...

1. We are learning more and more about closed head injuries/TBIs and I think starting to recognize them more and more, and seeing that in some cases, even "mild" brain trauma can have lingering effects.

2. Looking at things from the other direction...just as Fuzzy asked above... People with ADHD are more likely to experience head injuries and other accidents, thanks to impulsivity and inattention (both as children and as adults, documented well by research). So there may be some bidirectionality there -- and unless you have good pre-injury measurements of cognition and behavior, it can sometimes be difficult to tell which came first, the ADHD(-like symptoms) or the head injury.

Interesting topic!

Fraser_0762
02-01-12, 02:23 PM
I was attacked by 30 odd thugs a few years ago, just down the road from my house. They wrestled me to the ground and I took a lot of hard kicks to the front of the head. I remember when I came back round again, somebody was helping me back into my house. I just went straight to bed. When I woke up the next morning, I had a huge lump on my forehead which took many many weeks to go down. I reckon for the past few years, i've certainly been more "aware" of my concentration difficulties and it may be possible that this occurance has made my symptoms worse and much more obvious than before.

Although its not the first time i've recieved hard knocks on the forehead. I remember getting into a lot of fights in highschool and taking a lot of hard knocks on the noggin. I also used to walk into a lot of things and fall over a lot when I was young.

StoicNate
02-01-12, 03:05 PM
When I was 6 or so I landed on my head after being dropped by my aunt when being swung around like an airplane (one hand and one foot on one side).
I remember feeling mentally foggy and thinking I'm in a dream right after. Never been to a doctor for it.

Coincidentally, a year or so later I was diagnosed with ADHD.
So maybe that accident contributed even more to me getting diagnosed with ADHD? Who knows.

cameron90
02-01-12, 06:40 PM
I don't have any experience (or knowledge) of this and I'm also not saying that this is the case with you but I was just wondering if it is possible that people with ADHD are more accident prone?

I think that could very well be true, I only fell down the stairs so often because I was always running up and down them. Also, people with ADHD also tend to engage in high-risk activities like extreme sports.

Quick note 'cause I have to run, but...

1. We are learning more and more about closed head injuries/TBIs and I think starting to recognize them more and more, and seeing that in some cases, even "mild" brain trauma can have lingering effects.

2. Looking at things from the other direction...just as Fuzzy asked above... People with ADHD are more likely to experience head injuries and other accidents, thanks to impulsivity and inattention (both as children and as adults, documented well by research). So there may be some bidirectionality there -- and unless you have good pre-injury measurements of cognition and behavior, it can sometimes be difficult to tell which came first, the ADHD(-like symptoms) or the head injury.

Interesting topic!

Thanks for the info. It is a very interesting topic and one that very little is known, because of the complexities of the brain and neurological/psychiatric disorders. My TBI (mild) led to me going through a differential diagnosis for several candiate conditions: bipolar, schizoaffective, major depressive disorder with psychotic features, GAD, panic disorder, PTSD... I was not me at all, and the discharge summary of my behaviours is quite scary to read. All because of a bump to the head.

I think there could be some bidirectionality, but it's difficult to tell because I didn't have any proper assessments of cognition and behaviour pre-injury, only anecdotal reports from family/friends, my own memory (which isn't that great) and some report cards. Definitely a question or the chicken of the egg...

I was attacked by 30 odd thugs a few years ago, just down the road from my house. They wrestled me to the ground and I took a lot of hard kicks to the front of the head. I remember when I came back round again, somebody was helping me back into my house. I just went straight to bed. When I woke up the next morning, I had a huge lump on my forehead which took many many weeks to go down. I reckon for the past few years, i've certainly been more "aware" of my concentration difficulties and it may be possible that this occurance has made my symptoms worse and much more obvious than before.

Although its not the first time i've recieved hard knocks on the forehead. I remember getting into a lot of fights in highschool and taking a lot of hard knocks on the noggin. I also used to walk into a lot of things and fall over a lot when I was young.

When I was 6 or so I landed on my head after being dropped by my aunt when being swung around like an airplane (one hand and one foot on one side).
I remember feeling mentally foggy and thinking I'm in a dream right after. Never been to a doctor for it.

Coincidentally, a year or so later I was diagnosed with ADHD.
So maybe that accident contributed even more to me getting diagnosed with ADHD? Who knows.

Thank you for your accounts, I appreciate it. Those sound like some serious bumps. I'm sorry to hear about the attack, Fraser.

If ADHD is caused by neurological (i.e., biological) impairment to certain parts of the brain (pre-frontal cortex, frontal lobe, limbic), then head injuries seem a likely candidate as a risk factor. There isn't that much compelling evidence or studies that support the notion of acquired ADHD in previously unaffected people, or exacerbation of pre-existing ADHD. Then again, there are still many debates over the exact causes of the condition in general. I don't any reason why single concussion can cause psychiatric problems, seizures, personality changes, dementia or amnesia, deficits in speech or writing, and not something that is or resembles ADHD. Not to say that ADHD is a result of a "damaged" brain per se, but analogous to a TV having it's antenna shifted slightly so that the signal is less clear and there is a presence of "noise" or "static."

The notion of acquired ADHD is discussed by Dr. Barkley, which was brought to my attention by BR549 in another thread relevant to head injuries, ADHD brought on by Head Injury & Piracetam (http://www.addforums.com/forums/showthread.php?t=116890)

Actually, it IS intact considered ADHD. it's called "Acquired ADHD", as a result of a brain injury or diseases. Dr. Barkley discusses this, note the bolded sections:

Quote
Originally Posted by Russell Barkely
We know that about 10-15 percent of AD/HD seems to arise as a result of prenatal injuries to the development of the prefrontal cortex of the human brain. What are the most common injuries? They are multiple pregnancy complications, premature birth with minor brain hemorrhaging associated with it, cigarette smoking, and alcohol during pregnancy. Those are the big four. Those four will predispose to this disorder. So notice they create what we call acquired AD/HD. This is a normal child with a normal brain whose brain has been injured because of what’s happened in fetal development.

Second, post-natal brain damage, about 3-5 percent. What are the most common causes? Trauma, head injury—you whack the front part of your brain hard enough, you’re going to start getting symptoms of this disorder.
Second one: streptococcal infections. There are some individuals with genetically prone AD/HD or maybe not even prone to AD/HD who when they get a strep infection— which may, by the way, lead them to have cardiac abnormalities as well—that if they get a strep infection, a small percentage of the population has an auto-immune response to the strep bacteria, and that auto-immune response attacks the basal ganglia and the prefrontal cortex, but especially the basal ganglia. That was just discovered two months ago [in 2000] at Yale University.
So can you acquire AD/HD? Yes. About one in five AD/HD children is an acquired case. If you put those statistics together they tend to be mostly boys. Why is that? Because the male brain is more prone to injury, both prenatally and post-natally than the female brain.

www.greatschools.org/pdfs/2200_7-barktran.pdf?date=4-12-05 transcript of interview

So, yes, you can have acquired ADHD and it still be considered ADHD.[/QUOTE]

Some studies:

Long-Term Attention Problems in Children With Traumatic Brain Injury (http://www.jaacap.com/article/S0890-8567(09)61633-6/abstract)

Conclusion:
Childhood TBI exacerbates premorbid attention problems. Long-term behavioral symptoms of attention problems are related to the cognitive deficits in attention and executive functions that often occur in association with childhood TBI.

Inhibitory control in children with traumatic brain injury (TBI) and children with attention deficit/hyperactivity disorder (ADHD)

Abstract:
The behavioural and cognitive sequelae of traumatic brain injury (TBI) have features in common with attention deficit/hyperactivity disorder (ADHD), best characterized by deficits in response inhibition. The performance was, therefore, examined of 27 children with TBI, 31 children with developmental ADHD, and 26 matched controls aged 8?12, on two inhibition tasks: the Stop-Signal Task and a Delayed-Response-Task. Children with TBI and children with ADHD showed a pervasive deficit in their inhibitory control processes with respect to inhibition of both pre-potent and on-going responses. In addition, children with TBI were found to suffer from a general slowing of their information processing, which was not correlated with the inhibition deficit. TBI children with and without a secondary ADHD differed only tendentially in their Mean Go-Reaction time in the stoptask. However, subdividing TBI children according to actigraph data into hypo-, hyper- and normokinetic subgroups revealed that the hyperactive TBI children had inhibitory deficit patterns that were similar to children with developmental ADHD. It is concluded that slowing of information processing speed seems to be a general consequence of TBI in childhood, whereas slowing of the stop-processes or inhibitory deficits, specifically, are associated with post-injury hypo- or hyperactivity.

[URL="http://www.jaacap.com/article/S0890-8567(09)63075-6/abstract"]Premorbid Prevalence of ADHD and Development of Secondary ADHD After Closed Head Injury (http://informahealthcare.com/doi/abs/10.1080/026990500445691)

Conclusion:
Premorbid prevalence of ADHD was 0.20, significantly higher than in a reference population (0.045). Fifteen of the remaining 80 children (0.19) developed full ADHD criteria (except for age of onset) by the end of the first year. Children who developed secondary ADHD (S-ADHD) had significantly greater premorbid psychosocial adversity, posttraumatic affective lability and aggression, posttraumatic psychiatric comorbidity, and overall disability than children who did not develop S-ADHD.

I wouldn't go as far as to say that a simple bump on the head could cause ADHD. But a bump on the head might possibly have an effect on the extremely complex mechanisms of the brain that may result in acquired or secondary ADHD. I don't think that my ADHD was acquired as a secondary condition, as I did show symptoms prior to my accident. But I think that it could very well be possible, especially if the TBI happens pre-natal or shortly after birth. I do believe that my head injury triggered my mental illness, because prior to the head trauma I had not experienced any symptoms related to my diagnoses, although I have a very significant family history of mental illness and thus a predisposition genetically. Then again, I also have a genetic disposition for ADHD, as my father was diagnosed as a child.

The exact causes of psychiatric, neurological, developmental disorders and conditions are still not entirely known, and there is ongoing debate in the professions of psychiatry and neurology due to the complexity of the human brain. If anybody has anything to add, or any studies, theories, thoughts -- I'm very interested to hear/read about it. Especially anything that is further into cognitive development, as much of the discussion around this topic tends to surround pregnancy and birth complications, or pre-natal injuries.