Caveat Emptor (Latin for buyer be aware). Many of my recent blogs are stimulated by very thought-provoking emails sent to me by sufferers. This is the case here. As I have mentioned in a prior blog, issues related to GDD not being recognized by the broad community of allopathic physicians, include that insufficient research is paid to it. The end result is the patients have to be their own advocates, and in fact own researchers- hence caveat emptor.
I have deliberately to date, shied away from discussing Multiple Sclerosis (MS) and GDD. Certainly what is clear, in older neuroradiology text-books, the finding of high signal in the Dentate Nucleus and Globus Pallidus in the brain, that had been thought to be due to MS, actually almost certainly reflects the presence of Gd in these locations in the brain (and ofcourse is present in other locations - some in vastly higher quantity: the bones and skin, as I have written about previously). Could some of the symptoms attributed to MS actually be due to GDD? Possibly, read my blog on GDD and concurrent disease; and I will expand on this in the future.
The issue that has been brought to my attention is traumatic brain injury (TBI) and GBCA administration to evaluate that condition. TBI almost for sure, and probably even with lesser forms such as concussion, can/will result in disruption of the blood brain barrier (BBB). It seems not unreasonable to think that this may aggravate the problem of Gd getting into the brain. We already know that Gd gets into the brain even in individuals with intact BBB, through a variety of mechanisms (still under research) but certainly even through simple passage into the CSF > which happens in essentially everyone. Instead though of a small faucet of Gd dripping into the brain in normals, does TBI result in a fire hose of Gd entering the brain? It is possible.
As essentially all sufferers know, I have been cautious in my assessment of the injuries due to Gd, much, as I know, to many of their chagrin. But I have to be step-wise, and either fact, or strong theory-based evaluation of the issues.That being said, a number of patient situations do make me nervous. TBI may be one of them. Caveat Emptor.