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The Winners and Losers of the Under-Diagnosis of Mild/Moderate
Traumatic Brain Injury in the USA
By E. Laing
The suffering and under-diagnosis of a Mild/Moderate traumatic brain injury
(MTBI) is becoming a rising public health problem across the United States.
Although there are primary preventative methods such as safety standards,
road engineering, and speed limits; Secondary efforts must be taken to minimize
the whole biological injury resulting from the trauma. Most brain injuries are
deemed to be only mild injuries that are caused by trivial blows to the head
or by the acceleration-deceleration forces without direct trauma.
Supporting studies and statistics show these injuries can create consequences
lasting as long as a year after the accident and possible longer term impairments
to the individual’s brain and livelihood due to the under-diagnosis of the
Mild traumatic brain injury.
The numbers are staggering at approximately 1,000,000 hospital visits per
year for traumatic brain injury. An estimated 50,000 die every year and 80,000
become permanently disabled because of the accident. According to the
Franklin Institute, one out of every five Americans is currently living with
disability from traumatic brain injury, which is also associated with Alzheimer’s
disease later on in life. If victims take the proper steps, they can come out
winners against their injury rather then lose to the long lasting impairments
and frustrations.
In a Mild head injury, the victim may go through a period of unconsciousness
lasting between 1-5 minutes. The post-injury syndrome usually involves damage
to the cerebral, cranial, and cervical areas. General symptoms include headache,
dizziness, concentration difficulty, lethargy, sleep disturbance, irritability,
confusion, emotional/behavioral changes, fatigue, hallucinations, and possible
slow reactions. Many symptoms may only last for a few days, but others may
last up to a year depending on the severity of the injury, which may not become
apparent until an extended period of time after the surgery because of the
internal progression of damage in the white tissue of the brain.
When a traumatic brain injury occurs there is damage to the axonal segment
of the body. The amount of damage done in the injury can be a good predictor
of the poor survival or poor condition of the patient in the future but it is
frequently under-diagnosed to a lack of tools with sufficient thresholds of
detection. A key focal point is also the amount of damage done to the white
matter tissue. An injury affecting the white matter has a degenerative process
that deteriorates tissue even after the initial trauma. Immunohistochemical
markers of axonal injury, advanced imaging technologies, and serum
biomarkers have proven this progressive process of the white matter which
occurs in both severe AND mild traumatic brain injuries. The lesions of
white matter are responsible for future ongoing neuro-cognitive issues
such as stress, greater discomfort, chronic re-injury, and feelings of mistrust
and resentment.
In order for the person who has suffered a traumatic brain injury to come out
a winner, they must have a comprehensive understanding of their injury and
receive proper neuropsychological treatment and services. The real winners
stand in those who are properly educated about their condition and continue
to have regular check-ups on the progression of their healing to prevent
possible extensive damage to their critical white matter and the axonal section
of the individual’s brain. Those who treat their injury as a minuscule bump
to the head will sorely lose to their injury and become victimized to future
negative and frustrating behavioral, emotional, and cognitive changes.
According to Dr. Swiercinsky, Neuropsychology is the scientific and clinical
study of how the brain controls behavior and mental functions. This involves
understanding how the brain influences emotions, personality, thinking,
learning and remembering, problem solving, and adjusting to life’s demands.
Those who wish to defeat the symptoms of their under-diagnosed brain injury
would be wise to receive a brief neuropsychological consultation in the early
stages following the injury. In many instances, persons are not referred to a
neuropsychologist until the dysfunctional patter of the brain trauma or injury
has already done a large amount of damage. An early consultation can provide
paramount assistance with education of all parties associated with the individual
and early identification of any problems, as well as therapeutic assistance.
A neuropsychologist will evaluate the following:
- Structural brain condition
- Deficiencies caused by brain trauma versus other conditions such as
pain, emotions, personality, and pre-injury conditions that contribute to
functional status- Strengths in cognitive and psychological skills
- Comprehensive diagnostic understanding of the physiological, psychological,
and cognitive impact of the injury- Extent of the injury and prognosis for recovery
- Specific treatment needs along with identification of barriers to and assets
for recovery- Objectively-based prognosis for return to work, school, and other activities
- Foundation for life care planning
The National Academy of Neuropsychology conducted a study using for different
groups in a scientific procedure. They concluded that approximately 75% of the
participants diagnosed with mild head injuries show significant psychological
impairment. The study also suggests “brain damage occurs in at least a small
proportion of persons who sustain a mild head injury, that these persons have
corresponding neuropsychological impairment, and are in need of comprehensive
neuropsychological testing.” The study also strongly recommends that health care
providers use methods that have proven to validly detect impairment in mild head
injury and evaluate the full range of variable neuropsychological functions that
may be impaired.
There are many ways to become a winner after suffering a traumatic brain injury.
In conclusion, ways to win include comprehensive education and the proper
neuropsychological treatment. Another suggestion would be to contact a
professional Accident Attorney for professional advice in the form of injury in
the case that you are entitled to compensation.Sources:
http://www.cmaj.ca/cgi/content/full/178/9/1163
http://www.fi.edu/learn/brain/head.html
http://horizon.clarkson.edu:2100/science?_ob=ArticleURL&_udi=B6VDJ-3VYXWYM-3
&_user=607434&_coverDate=02%2F28%2F1999&_alid=759933051&_rdoc=17&_
fmt=high&_orig=search&_cdi=5984&_sort=d&_st=4&_docanchor=&_ct=23&_acct=
C000031539&_version=1&_urlVersion=0&_userid=607434&md5=d3c4f4453e001
ef2522bb77a307dc30b
http://www.brainsource.com/assmbi.htm
