Find out the 2 types of stroke and why location, location, location is important. Left side, right side of the brain. Which is for rational thinking, and which is for creative thinking? What can happen if you suffer from traumatic brain injury? Find out the general tips on what to do if you suffer from a concussion. What is neuroplasticity? Can we train our brain?
Really simple it’s trauma to the head, so trauma to the head and that impacts on the brain. So as long as there’s kind of any brain injury, either through a knock or a direct hit, or it could be something what we call a closed head injury. And that’s when there’s actually nothing penetrating the head or the brain. But there’s actually the brain has been damaged, perhaps through shaking and so forth. And brain injury can also occur, what we call ischemic brain injury. And that’s when there’s not enough oxygen to the brain. So, brain injury can occur in lots of different ways. One is not enough oxygen and not enough blood. Or another one is where it’s actually blood is toxic to the brain. So when blood comes in contact with brain tissue, it actually eats away at it. So that’s another way of getting brain injury as well.
Well, it’s funny in business in the sense that, you know, it really depends on the person, not everyone. Some people have what we call opposite brains. So what they think is usually located in the left side is located on the right side. So it depends on the person, but in general as a overall human population since the left side of the brain is often associated with language function, and sequential and kind of what the what we call rational thinking, and then the right side of the brain is associated with more of the visual and the holistic side of processing information
Yeah, I mean, everything’s connected and we’re all working with systems it’ll make sense that the brain system or the neurological system does affect the body. We Internal effects , were everything else that we come in contact across. So, you know, if your sleep is not good, you probably not going to eat as well and you’re going to be irritable, which then means it’s gonna affect your relationships, which then might affect more of your sleep, and it’s just a potential in a negative loop that goes round.
Dr Judy Tang has over 10 years of career and academic expertise in Clinical Neuropsychology. With a Dpsych (professional doctorate) in Clinical Neuropsychology from Monash University (2008) and a Bachelor of Science with honours (majoring in psychology and behavioural neuroscience), she provides neuropsychological services for medico-legal and community settings, workshops and seminars both to her professional peers and wider community, as well as advocacy in the areas of health and community care.
She can be found at https://www.jurmainehealth.com.au/dr-judy-tang/
Episode 031: Chat with our senior neuropsychologist on traumatic brain Injury
Podcast brought to you by Jurmaine Health
This is Jurmaine Health, the center to help you achieve in wellness in both your brain and body. We endeavor to encourage cross communication between health professionals for your health and well being. We'll bring you topics on functional neurological health such as neuro psychology, neuro behavior, neuro musculoskeletal, neurogastro, the Embodied Project, metabolism, and microbiome, which are also some of the services that we provide. In today's podcast, we're interviewing the lovely neuropsychologist, Dr. Judy Tang, about her views on traumatic brain injuries. And I also have Dr. Shermain with me today.
So say Hello, guys.
JUDY + SHERMAIN [00:40]
So I believe Dr. Shermain will be the one leading today's podcast.
And I'm just here for the ride, guys.
Thank you, Jackie. So this is the first time you guys are hearing Dr. Judy Tang speak to us in our podcast. So hurray for that yaay. And we are very excited to have her speak more in the rest of the upcoming podcasts down the track for the rest of this year. And, however, we will be starting with interview questions for traumatic brain injury, concussion and its effects on people. So let's start with the first question. Traumatic brain injury.What is that?
Really simple, it's trauma to the head, so trauma to the head and that impacts on the brain. So as long as there's any kind of brain injury, either through a knock or a direct hit, or it could be something what we call a closed head injury. And that's when there's actually nothing penetrating the head or the brain. But there's actually the brain has been damaged, perhaps through shaking and so forth. And brain injury can also occur, what we call ischemic brain injury. And that's when there's not enough oxygen to the brain. So, brain injury can occur in lots of different ways. One is not enough oxygen and not enough blood. Or another one is where it's actually blood is toxic to the brain. So when blood comes in contact with brain tissue,it actually eats away at it. So that's another way of getting brain injury as well.
It eats away?
It eats away at it, well that's the way that I say it not in a scientific way.
But it's kind of like think of it like splashing a bit of poison that eats away at the brain because blood is poisonous to the brain.
So strokes, there are two types, there's bleeding in the brain and then there's not enough oxygen to the brain that causes the brain tissue to die off.
So would have been a � Yeah. Would there be a difference in a way that it presents from the different kinds of strokes
Generally it only presents differently according to where the brain injury occurs. So it's not really the method it's more the location
and how that impacts on that person.
So location, location location,
In this case the more expensive ones and will cause more damage so you really want the lesser expensive ones
to be living in the western suburbs.
So totally so it's the West
Coast, praying it's pretty important like
It's gonna be a dangerous thing for I really cannot pinpoint any area that is worth that is okay to lose compared to other areas obviously.
Not all of your brain.
OK, not all of your brain. Is it a myth, the right brain versus left brain thing? I'm just jumping topics here
Myth in what way as in the right brain? Well, definitely functions have been localized to just the left brain and just the right brain. So if you're talking about that, that's not a myth,
Which part of it is a myth is that you use more of your left brain for some reason more of your right brain for another thing?
Well, it's probably in the sense that, you know, it really depends on the person, not everyone. Some people have what we call opposite brains. So what they think is usually located in the left side is located on the right side. So it depends on the person, but in general as a overall human population, since the left side of the brain is often associated with language function, and sequential and kind of what the what we call rational thinking, and then the right side of the brain is associated with more of the visual and the holistic sideof processing information.
Very generally speaking.
That makes sense. And the next question I have for you be, can traumatic brain injury can come from, you know, a variety of causes, such as compression from sport, or accident or a fall. So they will experience a lack of emotional control for mental health, disrupted balance, disrupted sleep, this can have a long lasting impact on both the patient and their families. How do you navigate around those situations for, let's say, for the patient, for example, we can start with concussion first, because we just finished on concussion really last week.
In terms of acute concussion, as in when the concussion has just happened from our point of view is psycho education is the most important thing, because people are, as understand, quite understandable, quite anxious and nervous about what's just happened. And they're not too sure how to take it from there. So, you know, just really normalizing the symptoms that can occur. So mood changes, feeling irritable or feeling tired, or having what we call brain fog is all normal and associated with having a concussion. And if they do experience that, then it is to rest and recover from that concussion before returning to work or returning to physical activity.
And for our end of the town Body side, we would prefer to have a bit of intervention with like, for example, within a week, they should be walking, they should be moving, they should be reducing the inflammation in the brain. Testing for balance and all those kind of things. Do you think those things are useful?
Definitely. I think it's definitely useful. And it's not like we're saying, be a vegetable and do nothing for, it's gonna be quite hard anyway, in today's age to not do anything, literally even for 24 hours, from a psychological point of view, we will be asking person to rest to avoid, say, Netflix in perhaps for the first 24 hours because that's a lot of visual stimulation, audio stimulation, trying to keep the brain as relaxed, so that it allows them that time to recover physically, and also, cognitively, from things. Is that what you mean?
Yeah. And yes, definitely, I would agree that within the week, it is getting them back into physical activity to increase the heart rate in the blood pumping around because even though the blood is a poison, it does bring all the nutrients to the brain.
So how does that work? Explain that to the audience a little bit better. I don't know which way it is going to go. How does it work there? The blood is you for the layperson. How does it work, how is the blood useful, to work, supply nutrients and at the same time it is toxic to the brain?
It is. So we've got like the blood brain barrier is what they call so it's kind of you know, we're passing each other but not really touching each other and handing over packages
is the best way I can explain it so�
of the nutrients to nurture the cells on the brain without actually having to touch the blood itself, if that makes sense. So yeah, exactly. Blood never really comes in contact, but it just kind of passes by and passes the packages across, passes the nutrients across.
It's just osmosis.
A good osmosis. So let's say for example, if a person who has a concussion is not diagnosed
and their concussion becomes a prolonged response, will they experience a change in behavior?
If a concussion doesn't,
It's not diagnosed
It's not diagnosed
under diagnosed, or misdiagnosed?
Well, almost always, the majority of cases of concussion do resolve spontaneously, like within themselves if the person does rest, or even if they don't rest, I mean, the body and the brain, as you know, is quite amazing. It can fix itself. If in the unfortunate event, it does not then that becomes what we call persistent concussion syndrome. And that's where things like what's normally what should have recovered by then is still persisting so the person is still experiencing, say, for example, headaches and emotional changes and poor sleep and irritability, and thinking changes. So that's when they would come to you and I for assessment and treatment. And I forgot the question. What was the
behaviors, you were talking about behaviours, whether their behavioral changes will be seen.
Yeah, definitely the behavioral changes will be seen coz if you're not sleeping well, you could be grouchy. And also the concussion itself is going to be emotional changes. So there might be a bit more irritable doesn't take much for them to be a bit grouchy. And same thing if you've got a bit of brain fog your memory is not as good as it used to be that can come across as a different personality or a bit of a personality change in how you were before,
Okay, what are some of the personality changes like?
Almost always is usually complaints of fatigue, not being able to think as clearly as before, which means the person might get frustrated more easily.
I think perhaps a bit more irritable, a bit more grouchy,
Impulse, as in they become more impulsive. Hmm.
Possibly, I mean it depends on the person so that can present as well.
So it's one of the many manifestations.
Like it's not symptomatic. This is what you �
This is what you definitely turn into soon. No, no, no.
And some people might just, you know what we call emotional liability. So they might cry more easily, you know, all what we call, you know, be a bit more moody
As well. So it really depends on the person on how that might manifest. We were talking about, this is a digression. We were talking about mold, and how it affects you and me differently. So when I had it came in contact with mold, I got a bit aggressive. Whereas for yourself you didn't get aggressive, but you felt a bit down. So it's how the person reacts to it. So different
Okay. Some less popular research has shown that can lead to a higher risk of dementia down the road? Have you come across any traumatic brain injury, and the risk of dementia is quite there's a link to that. What's your stance on that?
I'm just waiting to see what the research says. So that my understanding is that there is some research out there, which will make sense it's like if you, let's just say Howie, Howie is our dog the clinic dog. We've all met Howie, you know, we know that Howie, when we before we adopted him, he had a car accident. And so his joints had to be, you know, fixed up and rehabbed and everything, which then places him at more risk down the track of having joint issues at older age. Same thing with the brain. Like if you've had a brain injury, it makes sense that down the track if that injury hasn't fully resolved, or has resolved has left scar tissue, or some damage is still around, then that would potentially impact brain development as we grow older, that there will be an increased chance for that.
Speaking on brain development then and the hot topic about neuro of neuroplasticity in brain development. So will we as people be able to train this, train up our brains or cells to prevent a risk of deterioration? You know?
I think so, I also know that I�m a bit of an optimist. So
I like to think so I mean, really, it's, it's so important to keep the brain stimulated and to always be a form of a learner, because that really, one of the things that we found is a big cognitive reserve has been able to reduce the risk of cognitive decline, so to speak, as we grow older so the more cognitive reserve in some ways more knowledge, more experience more simulation, it means that you've got a bigger brain in a way, which means you've got more brain cells. And this is just figuratively speaking, more brain cells to lose before you become much more cognitively or brain impaired.
So let's say for example, we're now that we don't have anything going wrong.
No that brain impairment occurs definitely with old age. So that's a myth that people think as soon as you get older, you know, the brain just starts to deteriorate or malfunction. That's not the case. There's research to show yes, some of the cells there are cell changes within the brain as we grow older, but our cognition is, does not have such a drastic change that people would expect. In fact, it improves sometimes.
We're not sure I mean that's one of the theories there's many many many theories on aging so there's a shortening of telomeres is an increase of oxidants is it and that's why that kind of
oxidation which you know attacks the cells and
so they haven't found the panacea for
the reason for why we age
unless you're looking into it for lobsters because apparently lobsters live forever.
Yeah, the only reason why they die is
Because we eat them, that's one
One is because they eat them. But the second one, I think, from memory it was because the way that they grow they eventually cannot sustain the energy to keep on
so they end up trapping themselves in their own body so to speak as this so there's something like that is really interesting. So I think a lot of researchers are looking into eternal creatures.
Yeah, probably find some really old lobsters around. If they're not already eaten.
Would you want to eat a really old lobster
Well, there might be extra big and tasty. I don't know. But no one's ever told us the age of lobsters like to �
compare Shermain every time now she sees a lobster tank. I wanted
to be younger, like the Marion's. I just learned marron, marron, marron, I just recently learned that marron is a kind of lobster like family crustacean and so the way that waiter or server was like. Hi, this is Marion and place a lobster the dish on the table. So we didn't know that was called a marron. We were like Hi, Marron. Is this your pet? You just killed your pet?
Order this in the room. Okay, so what are the common sporting, sports that suffer from concussion? Do you think that they have got to be more aware?
I think a lot of high impact sports are already quite aware of concussions such as AFL especially NFL as you've seen this huge research and support into that. And sure soccer players are also a quite you know that as well.
They don't pay attention to them
Especially in the lower leagues because they don't, a lot of the time that they have trainers on the fields or anything so a lot of the time
Players can get concussion and still be playing still.
So the concussion consensus statement the most recent one came out in 2016. And that's got all the different sporting bodies involved with them including FIFA. NRL I'm pretty sure and ice hockey and all the other groups so usually the high impact sports, especially in the higher up from what I'm hearing, are much more aware about concussion and are working towards reducing and being able to appropriately being responsible in their play. Yeah. Sounds like that's potentially not the case for the lower leagues. Yeah,
Yeah. Well, it made noise recently last week or something earlier this week about the AFL player next yet, another concussion. They're thinking he may not play until next season, because he's had 8 concussions since 2014
so probably just pull back
Yeah then they're trying to they're waiting on medical advice to see whether they he gets allowed to play or whether he's, that team done for the season.
Right? This is going to be devastating for the player heh. But well in the long term play now risk of dementia.
Yeah, well, the interesting thing is, you know, as we know, not every person who has many concussions necessarily end up getting a dementia.
Yeah, well, I'm talking about the risks. The risks jumps dramatically each time they have one or at the very least, the irritability and mood changes. That's what when you hear more about within the AFL communities
Because there's a neuro inflammation in the brain.
Well, and that's what seems to be happening and most of the time it comes along with whiplash and they are not treating the whiplash. So their entire body and system seems to fall into neurological health dysfunction. That�s how I see it. What do you think about that function? Dysfunctional in their neurological health. Will you agree or disagree?
Yeah, I mean, everything's connected and we're all working with systems it'll make sense that the brain system or the neurological system does affect the body. Which in turns affect everything else that we come in contact across. So, you know, if your sleep is not good, you probably not going to eat as well and you're going to be irritable, which then means it's gonna affect your relationships, which then might affect more of your sleep, and it's just a potential a negative loop that goes round.
Do you have any more questions for Dr. Judy Tang?
Yeah, AFL has definitely been quite on board with concussions. So that's quite good to see. And pretty sure a lot of schools are getting in on it, too. Probably needs to be a bit more awareness around schools and for children and play. And that's something that I guess we are all looking to see how we can spread that knowledge and awareness out there.
What are the top three take homes for someone who has persistent concussed post concussive syndrome?
Get it checked out. That's pretty obvious. Consider which one of the things as Shermain and Jackie knows, is I put in a lot of my reports recently that a person probably has untreated whiplash syndrome. And I've been quite surprised at how many people have come to me with persistent concussion syndrome, complaining about the cognitive side, and they have also complained about these physical symptoms and no one's really done anything about it. So I think whiplash is quite an important thing to consider. So if you've got like neck pain, while the other symptoms.
We do see a lot of whiplash symptoms in our clinic, at least within Jackie and myself, maybe we haven't really spoke to you about that. And some of them, a lot of their symptoms vary. Yeah. Yeah, there are symptoms a lot of the symptoms vary just it's very, and it's sometimes quite nebulous in its presentation. It's not quite clear. And we have got to do a battery of tests actually for them to know exactly what's happening. And that's quite common in so when we're talking about whiplash and concussion, rehab, post persistent post concussive syndrome rehab, I think that it's an amalgamation of different sets of treatment approach. Yeah. And a program would be a bit more conclusive and more complete as compared to having a little bit of this having a little bit of isolation, isolated approach by different people. And also�
Yeah,you're right. And also it's point to have a multi-disciplinary approach so that the Brain side does work with the Body side so we can really approach it as the person as a whole, a whole system, not just whiplash. And then that's it, or just cognitive symptoms as they've come to me and then that's it. So, yeah.
For those of you who have someone you know, will have had signs and symptoms of concussion or whiplash, post concussive syndrome. Please let them listen to or share this podcast with them and
Reach out to us, ask us any questions and also got a bit of information on the website and more to come as well.
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