Game of Thrones star Emilia Clarke has lost a bit of her brain. How do people survive and thrive after a brain injury?
In a recent interview, Game of Thrones star Emilia Clarke talked about being able to live “absolutely normal” after two aneurysms – one in 2011 and one in 2013 – caused brain injuries. He went on to undergo two brain surgeries.
An aneurysm is a bulge or balloon in the wall of a blood vessel, often accompanied by a headache or severe pain.
So how can people survive and thrive despite having, as Clarke puts it, “a little bit missing” from their brain?
The key to understanding how brains can recover from trauma is that they are highly plastic – meaning our body’s supercomputer can reshape and remodel itself.
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Our amazing plastic brain
The brain can adapt and change in extraordinary ways. You do it now as you form new memories.
It’s not that the brain has evolved to deal with brain trauma or stroke or aneurysm; our ancestors usually died when that happened and may not have continued to breed. In fact, we developed a very thick skull to try to prevent brain trauma from occurring at all.
No, this neural plasticity is the result of our brains evolving into learning machines. They allow us to adapt to a changing environment, to facilitate learning, memory and flexibility. This function also means the brain can adapt after a particular injury, finding new pathways to function.
Many organs will not recover at all after serious damage. But the brain continues to develop throughout life. At the microscopic level, you alter your brain to make new memories every day.
One and a half kilograms of this incredible soft tissue in your skull – with more power and capacity than even the most powerful supercomputer – has an incredible ability to adapt.
What does it mean to say a part of the brain is ‘missing’?
The brain needs a constant and stable supply of oxygenated blood. During an injury – for example due to an aneurysm, a sudden impact to the inside of the skull, a stroke, or surgery – oxygen supply can be disrupted.
Sometimes, a piece is removed surgically or an area dies from lack of oxygen.
For example, sometimes a person with epilepsy does not respond to medication. Thanks to incredible brain imaging techniques, we can potentially pinpoint the exact place in the brain when a seizure starts and eliminate parts of the brain.
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So how does the brain adapt after an injury?
Your brain has about 100 billion neurons and more than a trillion synapses (junctions between two neurons, where electrical impulses are transmitted). They are constantly updating themselves in response to new experiences, to store and retrieve information.
With a brain injury, the changes can be even greater; You get a certain rewiring around the injury. These synapses can rearrange themselves to work around the damaged part.
Axons (long, thread-like parts of nerve cells that can conduct electrical impulses) form nerve fibers that are sent to new places in response to signals they receive from the damaged area.
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But there is another form of plasticity called neurogenesis. It involves a small pocket in the brain where new neurons continue to be born throughout life. And there is evidence that after brain injury, these neural stem cells can be stimulated and migrate to the area of injury and make new neurons.
Neurorehabilitation may include physical rehabilitation and speech rehabilitation. And there is also research on the use of drugs to increase neuroplasticity. That may also apply to slower forms of degeneration such as in Parkinson’s or Huntington’s disease.
As Clarke notes, not everyone makes a significant recovery after a traumatic brain injury; many people experience ongoing disability.
Many factors influence how the brain responds to rehabilitation, including the extent and position of the brain injury, genetics, lifestyle, and life history.
Some people also experience personality changes after a traumatic brain injury.
The textbook case is Phineas Gage, who was involved in an accident in the 1840s that saw a metal rod pierce his head, destroying most of his frontal lobe. He was able to survive and recover but his personality changed.
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What can you do to give your brain the best chance at life?
I want to end with a message about the five factors of brain health:
diet: emerging evidence suggests a link between brain health and body health, including your gut microbiome, so ensuring your diet is broadly healthy is good for your brain, as well as your entire body
stress: chronic high levels of stress can be bad for the brain
sleep: we know good sleep hygiene is essential for a healthy brain
cognitive or mental exercise: it is uniquely beneficial for the brain and has the potential to slow brain aging
physical exercise: physical activity is just as good for your brain as it is for your body.
While you can’t do anything about your genetics, you can change your lifestyle to give your brain the best chance and potentially slow brain aging.
The healthier your brain, the more likely it is to be able to repair itself and heal if injured, and is more resistant to the negative aspects of brain aging, such as Alzheimer’s disease and other forms of dementia, so this can be delayed or prevented.
Read more: What is it about the human brain that makes us smarter than other animals? New research provides interesting answers
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