Prodrome Science™ — Webinar Series
Introduction to the frequently overlooked severity of head injury.
Dr. Goodenowe opens with a striking observation: most people have had head injuries, and most have passed them off. His position, backed by military studies, sports medicine research, and pediatric brain imaging data, is that this is a serious mistake. TBI is not something you rest off and return to play. According to Dr. Goodenowe, “there but for the grace of God go I” is the right frame — because the long-term consequences of a head injury, and who escapes them, has largely been a matter of blind luck. Until now.
The webinar presents three case studies: Dr. Goodenowe’s own brain (injured in 1977, monitored over four years of neuroimaging), his great-nephew Casen (a 17-year-old hockey player with recent and cumulative concussions), and Brenda (a car accident whiplash injury with no direct head impact at all). The thread connecting all three is the same: the brain, given the right biochemical support, can rebuild what was damaged.
Dr. Goodenowe distinguishes three types of head injury — a coup injury (like Casen’s hockey stick hit, where the object has some flex), a countercoup injury (like his own skateboard fall onto an immovable cement floor), and an acceleration-deceleration injury (like Brenda’s car accident whiplash, where the brain sloshes violently inside the skull without any direct blow). All three cause damage through the same mechanism: axons — the wiring that connects different parts of the brain — get physically torn or sheared.
In the first minutes after impact, according to Dr. Goodenowe, a massive biochemical burst occurs: calcium floods in, glutamate spills out, cell contents go where they shouldn’t. “If this doesn’t fix itself in the first few minutes, you don’t wake up from your TBI.” Simultaneously, cerebral blood flow drops to roughly 50% of normal — a protective response from a brain that senses its blood-brain barrier has been compromised and essentially shuts itself off from the body to attempt self-repair. That blood flow restriction can persist for months or years.
Then comes the part most people don’t know: a broken axon cannot be directly repaired. According to Dr. Goodenowe, oligodendrocytes — the cells that maintain the myelin sheath coating axons — will only myelinate an axon that is electrically active. A dead or disconnected axon gets no repair. Instead, the microglia (the brain’s immune cells) move in to clean up the debris. This is initially protective. But if the inflammation isn’t resolved, it becomes the problem: “Nineteen years after the fact, this brain is still inflamed. This microglial inflammation gets stuck in your brain and stays there forever.” He cites human brain studies measuring microglial activity at 14 and 19 years post-injury — still elevated, still damaging surrounding healthy tissue.
What makes TBI different from Parkinson’s or MS, and also more recoverable in a specific sense: the neuron cell bodies themselves are usually intact. The damage is to the axons and dendrites — which, unlike the neurons themselves, are constantly growing and adapting throughout life. “Axons and dendrites are constantly growing and adapting. That’s how we think. Any time your brain learns a new task, it has created new neurites and axons and dendrites for that particular task. Your brain is always growing.” The goal of the restorative approach is to support that natural neurite regrowth — providing the raw materials and calming the inflammation so the brain can reconnect what was severed.
According to Dr. Goodenowe, the standard medical response to concussion — the CDC’s “return to play” protocol of rest, then graduated return to activity — has been studied directly. In a brain imaging study of 66 university athletes across seven sports, scans taken at the symptomatic phase and again at medical clearance to return showed “absolutely no difference in their brain.” The white matter damage had not improved. In his view: “The brain has kind of adapted. It’s made a workaround. It has tricked everybody into thinking it’s okay, but it’s not okay.”
In 1977, Dr. Goodenowe fell off a skateboard in his basement, hit the back of his head, was hospitalised with brain swelling, and was sent home. He never thought much more about it — until his first advanced MRI scan in January 2022 showed residual damage that “didn’t look so great.”
Over four years of progressive biochemical support and serial neuroimaging, he reports the following changes in his own brain: right hippocampal fiber tracts increased from 1,000 to 2,300; total brain fiber connections increased from 235,000 to nearly 300,000; total cortical thickness increased from 2.38 to 2.43 mm (the opposite of normal age-related decline); and frontal lobe regions that were thinning at baseline progressively normalised. According to Dr. Goodenowe: “We are at the point where we can actually quantitatively, objectively measure the brain healing itself.”
Casen is Dr. Goodenowe’s great-nephew, a hockey player with a history of cumulative head impacts. His most recent collision left him with black flashes, emotional dysregulation, balance issues, a hand tremor, brain fog, and disrupted sleep. His doctor cleared him in two weeks. On the day he was cleared to return, the flash happened again — “it felt like I just got punched in my brain,” Casen says in the webinar. “Like a short-circuit feeling.”
Dr. Goodenowe presents Casen’s brain scan in detail. Despite being 17 with a naturally thick, well-myelinated cortex, the imaging shows clear damage: decreased neurite density at the injury site, visible disruption of fiber tracts in the direction of the hit, and thinning in limbic regions — the areas governing emotional regulation. In his words: “These areas are the ones that have been knocked down. That’s the power of looking at these things in a quantitative way — and these happen to be in the limbic areas, so emotional regulation type situation, which is a big struggle from head injuries.”
Brenda’s injury is particularly instructive because her head never struck anything. It was a whiplash — the brain sloshed violently inside the skull during the accident. Dr. Goodenowe describes the mechanism: “It’s like taking a bundle of wires that are connecting to your wiring harness and you just rip them sideways. The wires kind of hold together where they’re connecting, but they get sheared off.” Her scans show the characteristic diffuse white matter disturbances of this acceleration-deceleration injury type — spread across the brain rather than localised to a single impact point.
Dr. Goodenowe uses Brenda’s case to make a point that applies to millions of people: “Most concussions don’t show up on a regular MRI as a general rule. You need high resolution MRI to get this kind of stuff. But all concussions have these diffuse white matter disturbances — it’s very clearly observable on an MRI.” The fact that standard imaging misses it doesn’t mean nothing happened.
For TBI specifically, Dr. Goodenowe describes a sequenced approach. The first priority, he says, is calming the brain before stimulating it: “You wanna calm the brain before you stimulate the brain.” That means omega-nine plasmalogens for myelination, and mitochondrial support (acetylcysteine, carnitine, CoQ10, B vitamins) to handle the energy demands of an injured, hyperactive brain. He notes that a brain under TBI stress is consuming materials far faster than a normal brain: “It’s not because they’re malnourished. It’s because that hyperactive brain is going through more materials than a normal brain does, and the brain hasn’t been prepared for it.”
Once the acute inflammatory phase has settled, the focus shifts to neurogenesis — regrowing the fiber connections that were damaged. Dr. Goodenowe reports this is what his own scans show happening, most dramatically in the fourth year of his protocol. The neuroimaging technology now exists to track it objectively: “There’s no placebo effect on an MRI. You can’t fake your way into actual physical growth of the brain.”
In this webinar Dr. Goodenowe presents the neuroscience of TBI recovery — including his own brain scans taken 45 years after a childhood concussion — and what the evidence says about the brain’s capacity to repair itself.
To watch the full webinar: Watch Dr. Goodenowe’s Full Head Injury & Brain Resilience Webinar ↗
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