What could cause a dream-like experience after a fall?

Question

Hi doctor,

I was at a party, and one of my friends accidentally fell and knocked himself out cold, when his head hit the floor. He was only unconscious for about 30 seconds, but in that brief window, he started convulsing and shaking uncontrollably. It was insane to watch!

After he came to, he said he had a weird dream-like experience, where he felt like he had an out-of-body experience floating above himself. My question is, from a neuroscience perspective, what could possibly be going on in the brain during a short black-out period, that causes such an intense psychological phenomenon? I have read theories about neurons firing in weird ways during head trauma, but it seems so far-fetched. Please explain.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

During a short blackout period, such as a fainting episode or a brief loss of consciousness, several neurobiological mechanisms may be at play in the brain to cause intense psychological phenomena. While the exact mechanisms can vary depending on the underlying cause of the blackout, here are some potential neurobiological explanations:

1. Hypoperfusion or Decreased Blood Flow: A sudden drop in blood pressure, or a decrease in cerebral blood flow can lead to hypoperfusion of the brain (brain injury due to reduced blood flow), resulting in a temporary lack of oxygen and nutrients to the brain regions involved in consciousness, cognition, and emotion regulation. This hypoperfusion can disrupt neural activity and communication within the brain, leading to altered states of consciousness and intense psychological experiences.

2. Activation of Stress Response: Blackout episodes can trigger the body's stress response system, including the release of stress hormones such as cortisol and adrenaline. Activation of the stress response can lead to changes in arousal, alertness, and emotional processing, contributing to intense psychological phenomena such as feelings of fear, anxiety, or dissociation.

3. Disruption of Neural Networks: Blackout episodes may disrupt neural networks and functional connectivity within the brain, particularly in regions involved in consciousness, memory, and self-awareness. Disruption of these neural networks can lead to altered perceptions of reality, distortions in time and space perception, and intense emotional experiences.

4. Involvement of Limbic System: The limbic system, which includes structures such as the amygdala, hippocampus, and hypothalamus, plays a key role in regulating emotions, memory, and arousal. During blackout episodes, dysregulation of the limbic system may occur, leading to heightened emotional responses, memory disturbances, and alterations in consciousness.

5. Neurotransmitter Imbalance: Dysregulation of neurotransmitter systems, such as the serotonin, dopamine, and noradrenaline systems, can occur during blackout episodes. Imbalances in neurotransmitter levels can affect mood, cognition, and perception, contributing to intense psychological phenomena such as hallucinations, delusions, or emotional instability.

6. Individual Variability: It is important to note that individual differences in neurobiology, genetics, and psychological factors can influence the nature and intensity of psychological phenomena experienced during blackout episodes. Factors such as prior experiences, coping mechanisms, and resilience may also play a role in shaping individuals' responses to blackout episodes.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.