LF someone with expertise in brain development(left/right development after accident)

[StayTuned]

TL;DR: Looking for information about brain recovery after intracranial injury; more specific about the efficiency of neural network "reformation" and general information on how to optimize those processes.



A friend had an accident 4 weeks ago and hit his head really hard. His left side of the brain had a swelling and hemorrhage, because of which he had to undergo an operation to remove his left head plate. The operation started about 3 hours after the accident.

He spent ~6 days in an induced coma (3 days straight and then on/off because of lung problems), after which he underwent a almost immediate mental and haptic improvement from day to day. Today, he is quite able to talk and hold conversations as long as they are not longer than an hour top. His writing has improved quite drastically, although he's still missing a lot of words and misuses them often. He does perform above average in audio-visual reaction tests and he remembers everything you tell him to a certain degree (mostly limited by complexity of information).

Daily improvement can be seen, by now he can chat via phone. Just 10 days ago it was just brutal gibberish. His speaking is quite good in my opinion, considering that just 10 days ago he was barely able to clearly voice himself.

Today, he seems obsessed with tattoos (he already has quite a lot, but he's voicing ideas of tattooing his whole body daily now) and gets frustrated a lot by things which seem rather unimportant. He has also... kinda lost his "decency". He became incredibly blunt. He tells people straight up things like "wow, you are so fat. That's disgusting", and doesn't seem to loose a 2nd thought about it. His ability to concentrate on things which are interactive is impaired. For example, he just can't beat stronger opponents on Pokemon (like guild masters), while he can easily beat the random trainers around him. This example is to show just how far he can think into the future and make plans. Combinations and action-reaction procedures are too complex for him.

He does understand the position he is in though, and feels that something is weird with him for not being able to perform those tasks, because he remembers doing them in the past. He even says that he thinks things through, but when he has to say something, or perform something, he can not deliver.


His plate is still removed because the swelling is not gone completely. Conservative estimate for the 2nd operation to reattach his plate is in 2-3 months from now on. He is in rehab, and allowed to leave freely over the weekend.

So far about the accident and medical development.

Now, I basically have two questions:

1) There are obviously damaged parts in the left part of the brain, and possibly also in the right part of the brain because the swelling of the left side pressed the ride side against his head. Damaged brain parts do not heal anymore AFAIK, but the brain has some sort of self-recovery, insofar that the neurons create new paths in order to make up for the lost ones. Generally speaking, how efficient is this process? Can you even think about a full recovery in terms of personality, logic, speaking/writing and reading?

2) The 2nd question is more a curiosity of mine. If the brain is efficient in creating new paths, is there a possibility that those paths function in a highly efficient manner? Meaning, shorter connections, faster communication, and therefore simply "more power"?

I understand that nobody can give me a textbook answer like "here, this is the perfect answer to exactly your case". I'm looking more for literature, rule of thumbs and personal expertise/experience in this regard. I want to help him to recover as quickly and as thoroughly as possible, but for that I need to learn.

Thanks in advance.

[Annoying]

I'm going to start out with a warning. We don't allow medical advice on this forum. Any info that only a doctor should be giving isn't allowed. I understand that this post isn't actually seeking real medical advice (just seeking resources), but I don't want other posters to start offering it when it's not allowed. That being said:

He has also... kinda lost his "decency". He became incredibly blunt.

That's extremely common. A lot of people lose their "filter" after a TBI.

Generally speaking, how efficient is this process? Can you even think about a full recovery in terms of personality, logic, speaking/writing and reading?

This is almost universally a "no." Particularly on the personality. The others might improve to nearly what they were, but personality changes rarely recover.

As for the curiosity, I'm not sure we have a real answer to that. Mostly because we're not entirely sure how efficient they are in the first place.

[StayTuned]

I'm going to start out with a warning. We don't allow medical advice on this forum. I understand that this post isn't actually seeking real medical advice (just seeking resources), but I don't want other posters to start offering it when it's not allowed. That being said:

That's extremely common. A lot of people lose their "filter" after a TBI.
This is almost universally a "no." Particularly on the personality. The others might improve to nearly what they were, but personality changes rarely recover.

As for the curiosity, I'm not sure we have a real answer to that. Mostly because we're not entirely sure how efficient they are in the first place.

Thanks a lot. And yes, please don't give me concrete medical advises and stick to the rules in this regard.

In regards to the personality change. In my head, decency (what you call the filter) is a learned thing, and as such should be in the realm of things he can learn again, or is this assumption wrong?

Edit: Thanks for calling it TBI. Under this term I was already able to find fabulous literature. German literature is really lacking behind in these regards. He's a young person, just 22 years old. I assume his brain's plasticity should be relatively good.

[Ayla]

Thanks a lot. And yes, please don't give me concrete medical advises and stick to the rules in this regard.

In regards to the personality change. In my head, decency (what you call the filter) is a learned thing, and as such should be in the realm of things he can learn again, or is this assumption wrong?

Edit: Thanks for calling it TBI. Under this term I was already able to find fabulous literature. German literature is really lacking behind in these regards. He's a young person, just 22 years old. I assume his brain's plasticity should be relatively good.

When I think of personality changes, I think of Gary Busey. Filters can be learned, but at that point you are just developing a point of the brain that's underdeveloped, not damaged.

[Annoying]

Thanks for calling it TBI. Under this term I was already able to find fabulous literature. German literature is really lacking behind in these regards. He's a young person, just 22 years old. I assume his brain's plasticity should be relatively good.

Well, fortunately, there's a ton of literature on the subject. Unfortunately, that's because it's a very common injury. =(

[StayTuned]

Well, fortunately, there's a ton of literature on the subject. Unfortunately, that's because it's a very common injury. =(

It's almost comically retarded how easy something like this can happen. He fainted for a second because he has a naturally weak metabolism after standing up too rapidly and hit his head on the ground. This caused an internal bleeding in the brain. How fucked up....

But what I don't like about the general literature you can find on Google is the fact that it's almost non-scientific. It doesn't go into details, which I am seeking. I wanna do more than just "hold his hand and leave everything to the professionals"

In Germany, there's one professional for 100 patients, or so. He can only go to rehab three times a week, which I find utterly ridiculous.

[apples]

phineas gage

also

people on the internet will give you nothing but false hope

[hrugner]

I'm no expert, but here's some things to look at regarding behavior change and brain damage. I will try to avoid anything like medical advice, and if I say something that sounds like medical advice, that's just a slip up and I'm sorry.

Phineas Gage would probably be an interesting person to read up on, so long as you remember that many reports on him are exaggerated.

"Joe" had his hemispheres split to stop seisures, while this isn't the exact scenario you are talking about he probably has some difficulties similar to what you are seeing in your friend. The active filling in information he expects to have will probably seem familiar, as well as rationalizing actions and responses in an attempt to flesh out incomplete experiences.

I doubt he'd ever be exactly the same, and I imagine he'll experience more frustration as the differences become more apparent to himself. No, he won't be hotwired for genius and anything gone is gone, though his brain will attempt to flesh out the missing pieces of memory skill and response.

[StayTuned]

I worked in an institution for people with acquired brain injury and what Annoying said is exactly what I experienced.

https://en.wikipedia.org/wiki/Frontal_lobe
If that part got damaged, he might have some issues with decency since it's mostly regulated by that area.
It's hard to 'learn' something when the part of the brain that 'learns' it is damaged.

Though I have to say that I am not a doctor and that I don't know about this case.

Thanks. Stuss, Donald T.; Gow, Catherine A.; Hetherington, C. Ross "No longer gage": Frontal lobe dysfunction and emotional changes is exactly the type of book I'm seeking. The damage to the frontal lobe is exactly fitting each and every single symptom he has

The frustrating part is that I mostly find information about what the effects of a TBI are, but not what you can do to help recover the damage.

[Ripster42]

Thanks. Stuss, Donald T.; Gow, Catherine A.; Hetherington, C. Ross "No longer gage": Frontal lobe dysfunction and emotional changes is exactly the type of book I'm seeking. The damage to the frontal lobe is exactly fitting each and every single symptom he has

The frustrating part is that I mostly find information about what the effects of a TBI are, but not what you can do to help recover the damage.

There may not be anything really. If you're willing to pay for a subscription, I'm guessing JAMA and NEJM are both publishing papers on this as it's been an incredibly common injury in our wars this past decade+.

Edit: uh, suppose I should tell you what those mean, sorry. Journal of the American medical ass, and the new England journal of medicine.