How do we organize such a diverse array of functions for the brain? When someone has a #concussion, it’s rarely just one part of the brain that gets injured. The interconnectedness of the brain means that damage to one part means multiple functions will deteriorate.
So when someone comes in and they are feeling dizzy, their cognition is foggy, they have headaches, their heart is racing, how do we decide how to prioritize their care?
A concept developed by Dr. Matt Antonucci of Plasticity Brain Centers (@brainguru) helps to prioritize different levels of brain function. The good thing is that the areas of function seem to correlate with the anatomical organization of the brain.
In many cases the areas of the brain that responsible for survival are lower in the brainstem, where as the areas concerned with higher level thought processes are high in the cortex.
If your brain can’t control blood flow very well for survival, it is certainly not going to care if you can do complex mathematics.
So when we assess a patient, we have to prioritize the systems that will restore function at the bottom of the pyramid, because many of the systems on the top depend on the bottom portions working.
What does this look like practically?
If a patient had a concussion and their chief complaint is brain fog, many people will want to target their cognitive areas of the brain. But what if they have brain fog because they have undiagnosed #dysautonomia causing an erratic heart rate?
We don’t fully have the answers without a good exam, and every patient’s experience is unique, but this can give people a strong starting point to organize their recovery after a brain injury.