Lifelong Recovery from Neurological Injury

“Hey, that hurt,” he said. “I beg your pardon?” I replied. We stared at each other astounded. Given that I had pretty much just raked a forearm up the side of his thigh, one would not think this sort of statement would be surprising. But it was absolutely astonishing for the sole reason that he hadn’t felt any pain in that leg since having had his stroke about eight years previously.

“Wow, I felt that and it actually hurt,” he said with a huge smile. I was still standing there with my jaw hanging open but quickly snapped it shut to grin ear to ear. This gentleman’s right leg had been essentially numb to pain and a lot of sensation for eight years. And on that particular day something happened. He felt pain. And it was a glorious achievement.

Miracle or Science?

But what exactly happened that day?  In short the brain healed itself. After the brain sustains an injury such as a stroke (where part of the brain is deprived of oxygen causing brain cells to die) or a traumatic brain injury (such as a blow to the head causing damage), recovery begins.

We used to believe that recovery after brain injury was due to one mechanism – neuroplasticity. This is the brain’s ability to be plastic or changeable and adaptable. When challenged appropriately, circuits are basically rerouted and a different part of the brain takes over the function of the damaged part. Neuroplasticity is a known and well-research phenomenon.

The Adaptable Brain

Extreme cases of neuroplasticity have been demonstrated, such as this manwho was living a perfectly normal life when in his 40’s it was discovered that 90% of his brain was absent, having been replaced by fluid that had slowly squeezed out most of his brain. There is also this womanwho was 24 years old before it was discovered she had no cerebellum, the part of the brain that is responsible for balance, movement, and learning of physical skills. She was also living a normal and productive life.

The other mechanism by which recovery occurs is regeneration. We used to believe that the brain was the one part of the body that was not capable of regenerating cells and healing. Scientists have now shown this to be incorrect. Brain cells can in fact regenerate and things like regular aerobic exercise have been shown to enhance this process. The brain can in fact heal itself in the same manner that your skin can, albeit perhaps not to the same extent.

Old beliefs

Unfortunately, as in all things, old beliefs linger. There are still some who will say that there is a recovery window of two years after a brain injury after which no further improvement is possible. I have even seen a neurosurgeon standing in intensive care at the bedside of a child who had had a severe brain injury after being hit by a car about 48 hours earlier, and telling the family that the child before them, unconscious and with tubes sticking out everywhere was what they were going to have to live with forever.

This is simply not true. There is absolutely no time limit on recovery after a brain injury. The child who was in intensive care went on to lead a relatively normal life. My client started feeling pain in his leg eight years after his stroke. I have seen people 20 years post-stroke improve their balance and functional mobility.

The key to continued improvement is challenging the system just enough to nudge it along, but not so much as to overwhelm it.  This requires a skilled therapist and lots of perseverance. But it is possible. And don’t let anyone tell you differently.  Whether you have had a brain injury three years ago or a stroke 30 years ago, recovery is still and always will be possible. And that is an exciting thing to be a part of.

 

If you are interested in reading more about the amazing ability of the brain to recover, check out this TED talkby Dr. Jill Bolte Taylor – a neuroscientist who had a severe stroke and an amazing recovery. Her book My Stroke of Insight is a great read. The book The Brain that Changes Itself by Normal Doidge is also an excellent read on this subject.