There are many variables you may not have considered that will contribute to your recovery after a concussion. Your mental health, medical history, physical health, age, IQ, history of substance abuse, employment history—these are all factors that affect how quickly you recover and the extent of your recovery.
The brain is no different than the rest of the body. How you live your life, your medical history, your genetic makeup and any prior brain damage all affect your brain and the chances of recovering from an injury.
If you have a poor medical history before you suffer a concussion, your recovery may be affected. A history of chronic health or psychiatric problems including depression, ADHD and substance abuse reduce the likelihood of a full recovery. Generally speaking, the better a person was functioning prior to a brain injury the better he or she will function after. Those with higher IQ, more education, a higher degree of vocational success, who had maintained consistent employment, and were physically and psychologically healthy prior to the accident have shown to achieve better outcomes.
Another factor affecting the long term consequences of a concussion is age. Adults over 40 have a harder time recovering from a brain injury than younger adults. An older brain, just like an older body, will not recover as well from traumatic injury. Additionally, children do not recover as well as young adults because the injury interrupts the brain’s development.
What is Cognitive Reserve Capacity?
It is well known that prior head injuries will also decrease your chances of a full recovery. Having one prior head injury increases your risk three-fold that a same or lesser impact will cause long term consequences. Having two previous head injuries increases your risk eightfold. Having a concussion also puts you at greater risk for developing dementia or Alzheimer’s later in life. Your recovery could also be affected by your reserve capacity. Reserve capacity describes the mind’s resistance to damage of the brain.
There are two types of reserve capacity: passive capacity and active capacity (your cognitive reserve capacity). The concept of reserve has been used to explain the disparity between the degree of brain damage and its clinical manifestations. For example, reserve has been used to answer why a head injury of the same magnitude can result in different outcomes of recovery in different people. Cognitive reserve postulates that individual differences in cognitive processes or neural networks underlying task performance allow some people to recover better from brain injury. With every injury to the brain, your reserve capacity to heal from future injuries is reduced.
Passive Versus Active Models of Reserve
The passive model of brain reserve says that your reserve derives from the size of your brain or neuronal count. Larger brains, it is theorized, can sustain more damage because they have more neuronal support to normal functions. The passive model explains reserve in terms of your brain reserve capacity.
In other words, there are individual differences in every person’s brain reserve capacity to sustain brain damage and that once the brain reserve capacity is breached past a critical threshold (which is different for every person) then clinical or function defects will begin to be apparent.
Someone with pre-existing brain damage can tolerate less new brain damage than another individual without this underlying pathology: the preexisting damage reduces the amount of remaining brain reserve capacity, so the new lesion is sufficient to exceed the functional impairment cutoff. Completely depleting your critical reserve capacity can lead to Alzheimer’s or dementia.
The active model of cognitive reserve states that the brain is always trying to compensate for any brain damage by forming new networks. The active model explains reserve in terms of your cognitive reserve capacity. This model is used to explain why individuals with higher levels of intelligence, educational, and occupational attainment are able to sustain more brain damage before showing signs of dysfunction.
Although two individuals might have the same brain reserve capacity, the individual with the higher cognitive reserve capacity will be able to tolerate more brain damage before clinical impairments are evident. Thus, an active model does not assume that there is a fixed threshold at which functional impairment will occur. Rather it focuses on the processes that allow individuals to sustain brain damage and maintain function.
The concept of reserve is relevant to any instance when the brain sustains an injury and explains variation in healthy individuals’ performance, particularly when they must perform at their maximum capacity. Cognitive reserve has been used to explain why some people heal better than others, especially younger adults in comparison to older adults and those with no prior head injuries as opposed to those who have already sustained a concussion.
The process of healing after a TBI can be long and arduous. Many brain injury survivors never fully recover from their injuries. If you or someone you love is suffering from the consequences of a brain injury caused by someone else’s negligence, contact us. You may be able to recover compensation for medical expenses, loss of ability to work, loss of enjoyment of life and other losses you have incurred as a result of the injury.
Call us today to talk to an attorney who understands brain injuries. Every consultation is complimentary. We only charge a fee if we recover compensation for you in a settlement or win at trial.