The Most Common Physical Effects of Brain Injury

After a brain injury – particularly a traumatic brain injury (TBI) – the brain’s nerve cells may not send signals between each other as they used to. As a result – aside from a range of possible behavioral and cognitive issues – there will often be physical effects, which might get better quickly during recovery while others might take time or become a lasting problem. The more traumatic a brain injury, the more widespread and longer-lasting the effects will likely be. At the Mount Sinai Department of Rehabilitation Medicine we take brain injury and its effects on directly to help our patients resume active, healthy and independent lives. Our rehabilitation program is a made to suit the individual needs of each patient with a combination of cognitive, physical, occupational, neuropsychologicaland speech therapy. Our brain injury rehabilitation program is one of only two CARF-accredited programs in New York City and patients can also access our CARF-accredited outpatient services once they have been discharged from hospital. 

Below we will discuss the most common physical effects of brain injury and give tips to help manage them.

Headaches

Headaches are very common following a brain injury – thankfully they usually improve over time. For some the pain comes and goes; for others it is a constant. Headaches are often exacerbated by fatigue and stress. Ways to manage include mitigating your stress, resting in a dark and quiet place when the pain is at its worst and avoiding bright sunlight, alcohol and foods that might trigger a headache such as cold items, aged cheese and chocolate.

Poor Sleep

Changed sleeping patterns and poor quality sleep are both very common after a brain injury. It is usual at its worst in the early stages of recovery and will generally tend to get better as time progresses. Many patients will sleep during the day and be awake at night; napping is also common. To help manage poor sleep, do not use your bed for anything besides sleep and sex (e.g. watching TV), ideally have dinner four hours before bedtime and avoid caffeine and exercise once the morning has ended. 

Fatigue

For those who have suffered anything from a mild to a traumatic brain injury, fatigue will be extremely common. Patients will find that their stamina might be dramatically less than what it once was, with even small tasks like getting dressed or walking around the house becoming exhausting. To manage, take regular rest periods during the day, avoid overly taxing social and familial activities and when appropriate have your physical therapist create a safe exercise program to build up stamina. 

Balance and Mobility

Following a brain injury one’s sense of balance can be affected which can make basic mobility an issue. This is a common effect in the early stages of recovery, but it can go away over time with physical therapy. It is important to be aware of this issue and to lie down and rest when a dizzy spell occurs as falls are the leading cause of non-combat TBI. Ways to manage while working with your physical therapist include using a cane or other walking aid and making your home fall-proof by removing rugs, electrical cords and other items on which one could slip, fall and possibly cause another brain injury.

Sensory Impairment

As the brain controls all five of our senses, when brain injury occurs each is at risk of changing. Not much can be done about sensory impairment in the first year of recovery and a ‘wait and see’ approach is often taken in the hope that the patient’s senses will return on their own. The sensation of touch may be reduced, lost or exaggerated; eyesight may be affected and unable to be improved through glasses, taste and smell might go away completely, be altered or replaced with a metallic flavor and one might have muffled hearing or a ringing in the ears (one or both). The best tip is to be patient, know that sensory changes often improve or revert to pre-injury levels and to trust in the medical professionals looking after your rehabilitation.

If you, a friend or family member has suffered a brain injury and you would like to discuss the ways in which the Mount Sinai Department of Rehabilitation Medicine can help, please get in touch with us at (212) 241-6321.

What Are Stem Cells Solutions?

Researchers over the last decade have made remarkable strides in increasing the effectiveness of stem cell therapy says Dr David Spinner, a physician at Mount Sinai’s Department of Rehabilitative Medicine. In the last decade, there has been a tremendous amount of research that giving us ways of treating issues that otherwise were not healing. 

Stem cell therapy is a process that involves harvesting the most basic cells from bone, blood, or tissue to help regenerate previously untreatable conditions. It is most commonly used in cancer treatment, when cells or bone marrow has been damaged or destroyed by the disease, but it is also used at Mount Sinai’s Department of Rehabilitative Medicine as a treatment for degenerative conditions such as tendonitis or partial ligament tears.

Blood cells begin their journey in bone marrow, and, once blood cells have matured move into the peripheral blood system. If the bone marrow (the soft spongey tissue inside our bones) is damaged or destroyed by a degenerative condition or cancer, then the marrow cannot make normal blood cells. Stem Cell therapies will extract red and white blood cells alongside platelets at an early stage of their maturity in other parts of the body where they are properly nourished and transplant them into the damaged area.

We already mentioned that stem cell therapy is an effective treatment for people with degrative joint diseases, but it is especially good at treating damage to areas with poor surface of the cartilage. We can also use the therapy on rotator cuff disease or rotator cuff tears to amend damage before impossible to treat. A great method we adopt is concentrating stem cells after we have harvested them before putting them back into an area that is injured.

Stem cell is also a fantastic treatment for spine damage and knee damage caused by arthritis. If the spine or knee is inflamed around one or more joints the area will become increasingly painful and will gradually worsen if not attended to. This issue can be down to your genetics or lifestyle such as poor posture, bad lifting technique, or not enough moving. The stem cell therapy we outlined above is a promising treatment for arthritis all over the body, and can help you reclaim your life.

If you would like to learn more, or would like to visit a consultant or physical therapist for referrals, call us on (212) 241-6321).

Fluoroscopic guided procedure at Mount Sinai

 Although at first it may sound a new deep-clean toothpaste or a strange form of horticulture, a fluoroscopy is an important diagnostic tool we use at Mount Sinai’s Department of Rehabilitative Medicine. You may have recently been, or potentially be referred for one of these treatments with one of our specialists. This week, we want to walk you through this vital piece of equipment and some of important procedures.

Firstly, What Is A Fluoroscopy Guided Procedure?

Before we answer that, we need to tell you what a fluoroscopy is. It’s nothing scary, your physician safely injects a dye into an area which allows them to investigate localized problems – which as you can imagine is much better than any alternative which may involve surgery. Our physicians can move joints, check organ health, locate a foreign body, amongst many other things. When the dye is inserted into the numbed area you may be asked to move or remain still depending on the nature of the investigation. From this point, your physician can study moving body structures as an x-ray like beam is passed through the examined part of the body which is then transmitted onto a monitor.

A fluoroscopy guided procedure in that case is the practice using a fluoroscopy to aid in providing relief to arthritis, especially in the hip joint. The physician can use the guidelines and information feedback to inject numbing agents or anti-inflammatory medications with maximum accuracy.

Why Have A Fluoroscopy or A Fluoroscopic Guided Procedure?

More often than not, your physician will recommend you for this procedure as an investigative procedure that will further increase their understanding of symptoms, underlying problems, and recovery. Sometimes however, we use the guides alone as a diagnostic or in conjunction with other diagnostic or therapeutic media or procedures. The reason therefore varies depending on your situation.

Risks and Additional Notes

There is very little risk associated with fluoroscopic procedures, whether it investigative or procedural. However, if you are – or think you are – pregnant please divulge this information with us before the exam. Other options will hitherto be discussed.

You may be asked to change into patient clothing, and all provision will be provided. Remove all piercings and leave all jewellery. We suggest leaving valuables at home.

Eat/Drink – specific instructions will be provided based on the examination you are scheduled for.

Please notify the radiologist or technologist as to your allergies or sensitivities to medications.

If you have been recommended a fluoroscopic procedure and would like to do it with us at Mount Sinai, or if you are having one with us soon and would like more information, please contact us on (212) 241-6321) to see if our physicians can further help.

Protecting Yourself From Wrist Injury

Hand and wrist injuries are particularly common in basketball because of the nature of the game. Every aspect of the sport from shooting, dribbling, catching, passing, and rebounding puts the area in question at risk. If the damage to the wrist is significant it could lead a player to missing the entire season with their injury, and the problem can persist if the cause and symptoms are not managed correctly.

The most common accident in basketball is falling and landing. The extreme and sudden trauma to the area can cause bone to come out of location – especially if one lands in an awkward position. Falls can be made worse by an already weak wrist, which tends to come from repetitive motions which are found in dribbling. It can add to a surmounting issue of overuse of the wrist and cause severe damage. The weakening stress on the wrist can also come from outside of basketball, for example - people who have recently come off crutches or require strong wrist motion for work.

If you are suffering from a past injury, such as a bone fracture that did not heal properly – then the past strain or sprain may weaken the wrist, making future damage more severe and easier to come by. There are some also people who are born with weak ligaments which further increases the chance of damage and recovery period.

The two most common types of injury that come from these elements, as we briefly alluded to, are sprains and strains. Your hand and arm and held together by ligaments and tendons, which act like an elasticated tissue that holds bone together.  A sprain occurs when a ligament is stretched or torn and a strain when a tendon muscle is overused or weak.

There are some very easy symptoms you should look out for if you think you have damaged your hand in basketball. Ask yourself these questions:

·       Was there notable pain when you injured it?

·       Has there been pain, weakness or numbness in your wrist or hand since?

·       Do you have a feeling of something clicking popping inside your wrist?

·       Has the shape of your had changed?

·       Do you have trouble moving your wrist or hand?

If you answered yes to any of the questions above it is highly likely you have damaged your wrist, please contact our switchboard at (212) 241-6321 if you would like to talk to a physician.

Recovering from spinal cord surgery

Spinal cord injuries are the result of both accidents and lifestyle habits. We can avoid developing a weak spine by adjusting our lifestyles. Unfortunately, the same cannot be said for accidents. A car accident or slipping over can lead to tremendous long-term discomfort and pain with little we can do to prevent these damages, assuming you're wearing your seatbelt and not running on unstable surfaces. Nonetheless, there are ways we can tackle this issue using advances in medical science. Spine surgery can have incredible effects on your quality of life. Let’s investigate how you can plan your recovery after a surgery. Please note that timestamps are generalized and dependent on your health and recovery plan.

Spine surgery is one of the more common types of surgery, and most are minimally invasive.  Let’s take a look at what spine surgery can do for you.

Firstly, when you’re in the hospital, you may have one of these surgeries depending on what type of damage you have incurred.  

·       Diskectomy – surgery to remove all or part of your disk

·       Foraminotory – surgery to widen the opening in your back where nerve roots leave your spinal column

·       Laminectomy – surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back, to take pressure off your spinal nerves or spinal column

·       Spinal fusion – the fusing of two bones together in your back to correct problems in your spine

Your physician will give you a bespoke plan relating to your damage and recovery plan.

Depending on your surgery, recovery could take anywhere between 3 weeks to 6 months to recover. Other conditions that could affect your recovery is your lifestyle and bodily condition before the surgery.

Your bandages have a lifespan of approximately 9 days.  Check to see if the area has changed colour, swollen, or begins to open up. If this happens, contact your surgeon immediately. If there are no issues, you may begin to shower again. Wait 5 days before showering, and cover the incision with plastic wrap. Do not allow shower from the head to spray the wounded area. You should also want to avoid stairs for the first week or so.

Once a few weeks have passed, and the healing process is underway, you should be attempting to work your way into your previous routine. Before continuing your rehab, please note: do not sit still for extended periods of time, and inform yourself on proper posture by reading this. If you are supported by a brace or corset, you should be wearing it when sitting and walking, however, it would be unnecessary to wear the brace when you are sitting for short periods of time or using the bathroom at night. Finally, do not drive for the first 2 weeks.

Now is the point where, as opposed to what you should avoid, we can start looking at how you can actively help the healing process.

Around the 4 week stage, generally, you should be taking light walks to strengthen surrounding areas. Increase the speed or duration of the walk slowly. This allows the spine to heal itself within an active body and correct itself. A sedentary lifestyle will encourage previous problems to return. Continue to up your exercise slowly as your spine recovers.

Please note, you should contact your surgeon immediately if you experience any of the following:

·        Chills or a fever of 101°F (38.3°C), or higher

·        More pain where you had your surgery

·        Drainage from the wound or the drainage is green or yellow

·        Lose feeling or have a change of feeling in your arms (if you had neck surgery) or your legs and feet (if you had lower back surgery)

·        Chest pain, shortness of breath

·        Swelling

·        Calf pain

·        Your back pain worsens and does not get better with rest and/or pain medicine

·        Difficulty urinating and controlling your bowel movements

If this routine does not help, or you need medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine. A bespoke plan will be necessary if you suffer from other medical problems. Contact our switchboard on: (212) 241-6321

How Can We Deal with Being SAD?

We all feel unhappy sometimes, but depression is more than a feeling of unhappiness. It is a mental disorder that makes someone feel persistently sad for several weeks or months. Depression can be hereditary, triggered by another mental disorder such as a “low” in bi-polar disorder, a side-effect of drug abuse, but it can also be triggered by external forces, like the season. Seasonal affective disorder (SAD) is a type of depression that occurs at a certain time of the year, usually in the winter.

SAD manifests itself similarly to other types of depression. There is no way of accurately diagnosing depression without knowing a patient’s history and state-of-mind, as there is no “test” for SAD. Your health care provider can make a diagnosis by asking about your symptoms. There are two main ways SAD can affect your life, mentally and physically.

The mental effect of SAD can be as follows. As with all types of depression, sufferers will tend to experience a feeling of hopelessness in all facets of life and catastrophize events past and present. Due to this, sufferers of SAD will be unhappy and irritable, and may begin to withdraw themselves socially. The disorder may begin to make the patient feel the need to eat more (as weight loss is more common with other forms of depression).

SAD manifests itself physically as a need for more sleep, a loss of energy and ability to concentrate.

There is a loss of interest to the sufferer’s work, his partner and friends, and other activities (especially social activities). Their movements may become sluggish and, they will more likely than not become socially reclusive.

These symptoms are not mutually exclusive, and they usually feed into each other which make the disorder more difficult to cope with. The mental facets of SAD will reinforce the social behaviour and vice-versa.

If you, or someone you know, is suffering from a handful of these symptoms then it is worth visiting your physician. Your health care provider can make a diagnosis by asking a series of questions about your symptoms and history. They can also perform physical exam and blood tests to rules out other disorders that are similar to SAD such as chronic fatigue.

If you are struggling to make an appointment, or are unable to see a physician for whatever reason, we have some tips that will help manage your depression at home. Remember, it is always better to see your physician.

Some tips on dealing with SAD

Firstly, make sure you are getting enough sleep. A fully-grown adult should get between seven to eight hours a night – although some people may need as few as five, and some as much as ten. Know how much sleep you need, and make sure you are getting it. Oversleeping is never advised.

Make sure you are eating healthy foods. This doesn’t mean you need to eat bland food, it means you need to have a balanced diet. For example: make sure you are getting a healthy dose of vitamins and minerals every day and avoid binging on sugar and hydrogenated fats.

Do not use alcohol or illegal drugs, these often make depression worse – and have been correlated to suicidal thoughts during episodes of SAD.

Try to exercise often. Proven time and time again, exercise is a fantastic way of battling depression. Force yourself to start a social sport or activity, but most importantly – do activities that make you happy.

Learn to watch your symptoms and understand that you are dealing with a disorder. This is especially effective in the early days of SAD, it will allow you to take control of your disorder, change your routine, and book in to see your health care provider.

Finally, if you have seen your health care provider, make sure you take your medicines right away, and ensure you ask your provider how to manage any side effects. There is a multitude of ways of dealing with SAD that your health care provider can offer. Symptoms tend to get better on their own, but there is no “cure” for SAD. Tackling SAD is a matter of managing symptoms and learning to with the disorder.

Get medical attention immediately if you have thoughts of hurting yourself or anyone else.

How to Deal With Sciatica, The Do’s and Don’ts

How to deal with sciatica, the do’s and don’ts

This week, we are going to look at ways of managing sciatica. In our previous blog we looked at what sciatica is, and suggested some causes of the problem. To quickly recap, sciatica is the compression of the sciatic nerve – which in turn causes pain down the lower back, through the hamstring all the way to the foot. What is most important to remember when dealing with sciatica, is that is a symptom, and not the underlying problem itself.

The first step when dealing with sciatica is diagnosing the underlying issue. The root of the problem can be anything from a slipped disc in the spine, to a spinal stenosis, or in more serious cases, a tumor. It could even come from a small fracture in the hip. Although we can treat sciatica without dealing with the genesis of the problem, you are more likely to experience a reoccurrence of sciatic pain if we do not.

We recommend that if you suffer from sciatica, get a diagnosis on what caused it. That way we can deal with the pain alongside remedying the original problem, and reduces the chances of it reoccurring.

For now, let’s look at some of Mount Sinai’s recommendations for dealing with sciatica at home.

Conservative (non-surgical) treatment is best in most cases. When you are suffering from sciatica, or begin suffering due to some other cause, apply heat or ice to the painful area. Try the ice first (48-72hrs); then use heat on the pain. Over the counter pain relievers such as ibuprofen or acetaminophen can also help with inflammation and general pain relief.

Surprisingly to a lot of patients, bed rest is not recommended. Although short term bed rest may be needed for patients in extreme pain, staying inactive and reclined for long periods of time weakens the body and extend the life of agonizing symptoms.

Upon first suffering the symptoms of sciatica, it is recommended to tone down your physical activity for the first few days, and gradually work your way back to your daily routine.

You should reduce your activity in the first couple of days – and gradually adjust your body to your usual activities. This will ensure you do not overstress any of the damaged components, and give your body time to adapt.

Patients are recommended to start exercising again after around 2-3 weeks. You should include exercises to strengthen your abdominal muscles and improve flexibility in your spine.

If weightlifting or contact (collision) sports such as American Football are part of your usual exercise routine, you should not return to your sport/hobby for at least 6 weeks since the pain began. Do not lift heavy objects or twist your back. Your physician can help identify good exercises to remedy sciatica.

More serious complications depend on the causes of sciatica, such as slipped discs or spinal stenosis. Call a provider immediately if you have:

·        Unexplained fever with back pain

·        Back pain after a severe blow or fall

·        Redness or swelling on the back or spine

·        Pain traveling down your legs below the knee

·        Weakness or numbness in your buttocks, thigh, leg, or pelvis

·        Burning with urination or blood in your urine

·        Pain that is worse when you lie down, or awakens you at night

·        Severe pain and you cannot get comfortable

·        Loss of control of urine or stool (incontinence)

Also call if:

·        You have been losing weight unintentionally (not on purpose)

·        You use steroids or intravenous drugs

·        You have had back pain before, but this episode is different and feels worse

·        This episode of back pain has lasted longer than 4 weeks

Sciatica usually goes away on its own if you follow our guidelines. However, if you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

How we can help diagnose Carpal Tunnel Syndrome

The carpal tunnel is the space between a group of eight small bones in the wrist joint, and the ligament that links them to the lower neck. Carpal Tunnel Syndrome (CTS) is a medical condition which compresses the median nerve as it travels through the wrist at the carpal tunnel. The median nerve starts at C5 to T1 (the middle lower part of your neck), and travels down the front of the elbow, and into your hand. The nerve gives feeling to parts of your hand. Symptoms materialise as pain, numbness, and tingling in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Due to this, sufferers tend to lose grip strength and if the problem persists, muscles at the base of the thumb may begin to waste away. 

Chances of suffering from CTS increase with obesity, repetitive wrist work, pregnancy, and arthritis. Diabetes has also been shown to have a weak correlation with CTS. There are some things you can do at home to help with CTS. But how can you know if you have CTS?

It has been suggested that there are exercises you can do at home to trigger the median nerve to exaggerate the symptoms. By placing our hands together as if one were praying, and ensure our forearms to our elbows are in a horizontal line, people suffering from CTS are said to feel their symptoms exaggerate. However, this is not a full diagnostic – and will not suffice to tell you if you are suffering from CTS.

We offer full a diagnostic test. An electrodiagnostic supplies us with objective evidence that will tell us if you are suffering from CTS or another medical condition. This helps rule out other medical conditions that mimic the symptoms of CTS, such as cervical radiculopathy.

The symptoms of CTS are equivalent in many ways to cervical radiculopathy (a neurological condition characterized by dysfunction of cervical spinal cords). With home tests, it is easy to conflate the two. Both issues result in numbness pain and weakness in the hand. With an electromyography, physicians can identify not only if you are suffering from CTS, but also – exactly where along the median nerve the problem lies. The root of the problem could be proximal to your lower neck, the median nerve itself, or the three fingers. Our diagnosis will precisely pinpoint the genesis of the condition.

The electrodiagnostic also identifies if patients are suffering from what is called double crush syndrome, where patients suffer from both CTS and cervical radiculopathy – which is increasingly common.

It is important that if you are experiencing the symptoms, you contact us immediately to discuss options. CTS is most easily treatable in the early days, the longer it is left, the higher chance of irreparable damage being caused. Get an accurate diagnosis.  

Mount Sinai specialize in CTS and pain management. If you experience any of the symptoms listed, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 659-8551 or (212) 590-3300

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is the compression – and sometimes squashing – of the median nerve that passes through the wrist. Its symptoms can include numbness, tingling and pain in the thumbs, fingers and wrists, which can travel as far as to the arms and even to the shoulder. Modern medicine has a firm grip on what CTS is; what causes it is quite a different story.

Diagnosing CTS can be done through a relatively simple physical examination. One test is called the ‘flick signal’, for which the patient is asked, ‘what do you do when your symptoms are worse?’ If the patient responds with a hand movement that resembles the shaking of a thermometer, there is good reason to suspect CTS. There are plenty of other tests such as Phalen’s Test and Tinel’s Sign – yet, despite the relative wealth of ways to diagnose CTS, there actually isn’t any kind of test to identify the precise cause CTS, and – except for patients suffering from underlying diseases – the biological mechanisms that create this inflammatory disorder remain unknown. 

It is a common story that CTS is caused through repetitive and often high-stress tasks that involve the wrists and hands – typing, using a computer mouse, manual labour to even playing the piano. While the correlation between CTS and tasks of this nature is undoubted, there is minimal evidence to suggest any clear causality.

In fact, most studies today indicate that CTS’ causes go above and beyond mere so-called ‘workplace factors’ and that they are rather linked to ailments that cause swelling in the wrist (osteoarthritis and rheumatoid arthritis) and others that obstruct blood flow (hypothyroidism and diabetes). We also see CTS pop up in clusters within a family, which suggests that something genetic is at play. Lifestyle also appears to play a significant factor, as those who smoke, drink alcohol excessively, consume excessive salt and who are obese all show increased risk of developing CTS. Women are also three times more likely to develop CTS than men, particularly after childbirth and during menopause.

Despite the range of medical, physical, genetic and life-style related items that are linked to an increased risk in developing CTS, their relationship is that of a correlation and not one of cause and effect. A modicum of clarity might be achieved, however, by overlapping both ends of the spectrum – the ‘workplace effect’ with medical/genetic/lifestyle factors. When somebody is susceptible to CTS – whether it be through genetics, a medical condition or an unhealthy or stressful lifestyle – and they also subject their hands and wrist to frequent, repetitive task, the likelihood of suffering from CTS will be at its greatest.

If you believe you are at risk of developing CTS, we would like to encourage you to seek medical advice on how to prevent it; if you believe you might already be suffering from it, we suggest you speak to one of our specialists for a suitable treatment. The earlier CTS is treated, the more likely – and easier – a full recovery will become.

Neuroplasticity – The Brain's Repairing Mechanism

 Injuries to the head can result in long term damage to areas of the brain, varying depending on where on the head the injury was sustained. While a variety of therapeutic services can be employed to regain a certain level of functionality the brain also has a unique response to regional damage – neuroplasticity.

Neuroplasticity is the brain's ability to reorganize itself through lifetime creation of new neuron pathways. From birth developmental plasticity begins, as neuron branches and synapses form to process new sensory information. At the age of two or three, a child's brain has around 15,000 synapses per neuron. This is around twice as many as in the adult brain as neurons strengthen, weaken, and are eliminated with age. While this process slows down, the brain retains the ability to grow new neurons throughout life in response to new stimuli. One such circumstance under which the brain may begin to regenerate in this way is when a certain area of it is damaged.

Known as functional plasticity, in response to an area of the brain loosing functionality, often the surrounding healthy areas will take over those processes, restoring former abilities. Neurons which remain undamaged will grow new nerve endings to create new connections where the original links were broken due to injury. As well as restoring connections, undamaged neuron axons can create entirely new pathways, developing nerve endings that connect with other undamaged neurons, to carry out necessary functions. Especially in children, when damage is sustained in one hemisphere of the brain, the corresponding area in the other half of the brain may take on functions traditionally performed in the initial hemisphere.

One example of when natural adult neurogenesis (formation of new neuron endings) can occur is following a stroke. Strokes are caused either when a blood clot prevents sufficient oxygen flow to the brain or when a blood vessel bursts leading to internal bleeding in the head. If left untreated, a stroke can cause certain areas of the brain to cease to function. Strokes can cause long-lasting physical and psychological problems, however, the brain may attempt to compensate for permanent localized damage by re-routing function pathways.

Head injuries can cause debilitating damage that leave the patient with reduced functionality. Therapeutic rehabilitation, such as physiotherapy, occupational therapy, and speech therapy can go some way to recovering a patient's abilities, however, the body's natural propensity to repair itself, many also contribute to patient recovery following a localized head injury.