Traumatic Brain Injury: The Critical Role of the Family in the Journey to Diagnosis, Treatment, and Recovery
Website design By BotEap.comBrain injury is one of the leading causes of death in people under the age of 45. Many who suffer mild to moderate injuries do not appear to be injured and have few outward physical manifestations of personal injury. Ultimately, they “remain” well, despite the fact that they have suffered severe personal injury that can mean job loss, the destruction of personal relationships and the anguish that accompanies the knowledge of all that has been lost.
Website design By BotEap.comDoctors assure mild to moderate traumatic brain injury survivors that they will recover from their fatigue, slow thinking, and reduced memory, just as they expect to recover from cuts, bruises, and broken bones. The all too common belief is that time heals all wounds. To every rule there is an exception and unfortunately time does not heal all traumatic brain injuries. Over time, doctors address objective physical injuries, but head injury does not receive the special attention it requires, and traumatic brain injury goes undiagnosed. As a result, many patients with head injuries and permanent disabilities never receive a full evaluation by a neuropsychologist, including neuropsychological testing. Without testing by a neuropsychologist, this personal injury cannot be diagnosed and these patients never receive adequate care and treatment for their physical, cognitive, psychological, sexual, and social impairments. A complete kit is essential because it contains all the detailed evaluations and objective measurements by emergency medical technicians, emergency nurses, and physicians and neurologists that are necessary to understand the nature and extent of this personal injury.
Website design By BotEap.comSince the brain regulates our state and level of consciousness, we can learn a lot about the extent of brain injury by assessing one’s own consciousness. If the level of consciousness is not normal, the head injury is serious, regardless of what a physical examination or other evidence indicates. The categories of altered consciousness are:
After 3 to 6 months, if deficits persist or improvement is slower than expected, report more significant deficits in writing to the primary care provider and request referral to a neuropsychologist. Website design By BotEap.comIn many cases, as the attorney for the head injury survivor, I have worked with family members to prepare a detailed letter to a treating physician that identifies changes in learning, communication, and other skills experienced by the patient and how As a result I have obtained a referral to a neuropsychologist for evaluation and testing. Getting the proper medical care and treatment, especially for TBI survivors, requires the intervention and support of family members and often a qualified attorney who knows and understands the signs and symptoms of brain injury. Website design By BotEap.comA word of caution. Don’t be discouraged if a doctor refuses to order neuropsychological testing because a CT scan or MRI shows no lesions—that is, the images read as if they were within normal limits.
First of all, CT scans cannot be used to diagnose TBI except in the most severe cases of fractures and bruises. Second, the same is true for most MRIs. Unless the MRI was performed on a T-3 MRI machine, which employs sophisticated software to provide diffuse tensor and fiber tracing images that are studied and interpreted by a neuroradiologist trained in this protocol, the report from MRI is not definitive. Website design By BotEap.comNote that an MRI using a T-3 alone is not sufficient unless software that provides diffuse tensor and fiber tracing images is used. This combination of hardware and software allows specially trained professionals to identify axonal nicks and other finite lesions not otherwise seen on MRIs performed on T-1 or T-1.5 machines. More importantly, MRIs are not the first step in diagnosing traumatic brain injury. The recognized method of diagnosing the remnants of traumatic brain injury is through testing by a neuropsychologist trained to assess for TBI.
When should a recovery be expected and to what extent? The general rule is that the shorter the recovery time, the more complete the recovery. Although each person is different, patients tend to recover sensory, motor, and language skills faster and more easily than writing and math skills, memory, attention, general intelligence, and social/emotional balance. In addition to the longer recovery time, the loss of these skills and abilities is often more devastating. Website design By BotEap.comMotor and speech recovery usually occurs within three to six months of injury. Attention and memory are usually the most difficult to recover. Website design By BotEap.comThe rate of recovery is usually greatest during the first three months. The recovery then tends to slow down over the course of the first year balance. This is one of the reasons why it is valuable to obtain a neuropsychological evaluation soon after the head injury and use this baseline to compare with subsequent tests to measure changes and understand the degree of improvement. Website design By BotEap.comIn general, after six months some improvement may occur, but it is usually not significant. After that point, there is no healing in the conventional sense. Damaged brain cells and nerve pathways do not regenerate. People can and do learn to compensate for their injuries through the use of other skills and that is where rehab specialists come in handy.
- Confusion – The mildest form of altered consciousness, in which individuals have difficulty thinking coherently. For example, they may not be able to solve a simple math problem or remember what they ate for breakfast. They will often seem disoriented and may not talk much.
- stupor – At this level, people are often close to a comatose state and unresponsive to normal stimuli. They can only be aroused by intense or painful stimulation, such as having their toes pinched or being pricked with a pin. They can open their eyes, but only if forcefully forced to respond.
- Delirium – This intense state of altered consciousness is often the result of exposure to a toxic substance. People with delusions are disoriented, fearful, irritable, and hyperreactive. They have no idea what they see or hear, and are prone to visual hallucinations.
- Eat – The most severe form of impaired consciousness, in which a person is completely unconscious and does not respond to any kind of stimulus.
After 3 to 6 months, if deficits persist or improvement is slower than expected, report more significant deficits in writing to the primary care provider and request referral to a neuropsychologist. Website design By BotEap.comIn many cases, as the attorney for the head injury survivor, I have worked with family members to prepare a detailed letter to a treating physician that identifies changes in learning, communication, and other skills experienced by the patient and how As a result I have obtained a referral to a neuropsychologist for evaluation and testing. Getting the proper medical care and treatment, especially for TBI survivors, requires the intervention and support of family members and often a qualified attorney who knows and understands the signs and symptoms of brain injury. Website design By BotEap.comA word of caution. Don’t be discouraged if a doctor refuses to order neuropsychological testing because a CT scan or MRI shows no lesions—that is, the images read as if they were within normal limits.
First of all, CT scans cannot be used to diagnose TBI except in the most severe cases of fractures and bruises. Second, the same is true for most MRIs. Unless the MRI was performed on a T-3 MRI machine, which employs sophisticated software to provide diffuse tensor and fiber tracing images that are studied and interpreted by a neuroradiologist trained in this protocol, the report from MRI is not definitive. Website design By BotEap.comNote that an MRI using a T-3 alone is not sufficient unless software that provides diffuse tensor and fiber tracing images is used. This combination of hardware and software allows specially trained professionals to identify axonal nicks and other finite lesions not otherwise seen on MRIs performed on T-1 or T-1.5 machines. More importantly, MRIs are not the first step in diagnosing traumatic brain injury. The recognized method of diagnosing the remnants of traumatic brain injury is through testing by a neuropsychologist trained to assess for TBI.
When should a recovery be expected and to what extent? The general rule is that the shorter the recovery time, the more complete the recovery. Although each person is different, patients tend to recover sensory, motor, and language skills faster and more easily than writing and math skills, memory, attention, general intelligence, and social/emotional balance. In addition to the longer recovery time, the loss of these skills and abilities is often more devastating. Website design By BotEap.comMotor and speech recovery usually occurs within three to six months of injury. Attention and memory are usually the most difficult to recover. Website design By BotEap.comThe rate of recovery is usually greatest during the first three months. The recovery then tends to slow down over the course of the first year balance. This is one of the reasons why it is valuable to obtain a neuropsychological evaluation soon after the head injury and use this baseline to compare with subsequent tests to measure changes and understand the degree of improvement. Website design By BotEap.comIn general, after six months some improvement may occur, but it is usually not significant. After that point, there is no healing in the conventional sense. Damaged brain cells and nerve pathways do not regenerate. People can and do learn to compensate for their injuries through the use of other skills and that is where rehab specialists come in handy.