Head Injury

I met a person yesterday that reported they hurt their back and neck.  They had no idea why they were being referred to a neuropsychologist.  So I started going through a symptom checklist for brain injury.

Do you have headaches?
Do you have memory problems?
Do you have problems with thinking and processing information?
Do you have difficulty with balance and coordination?
Do you have problems with controling your modds?
Do you feel anxious or depressed?
Have others said that you seem changed since your accident?
Do you get lost?
Do you forget words?
Has your vision or hearing changed?
Do you have difficulty feeling "stuck" and having problems starting something, stopping something or changing from one thing to something else when what you are doing isn't working?
Do you have difficulty doing something you used to be able to do?

After he answered yes to most of those questions, we discussed his brain injury.  He had actually lost consciousness briefly when he hurt his neck.  Further he had a prior neck and brain injury which made his most recent injury more complex than it would have been if it was his first injury.  Although he's been seen, evaluated and treated by three different medical specialists he had no idea he'd had a likely brain injury at the time of his accident.

Brain injuries generally improve over time.  They continue to improve for at least 10 to 15 years and maybe longer.  People will often just start recognizing their symptoms over the first 18 to 24 months so it may appear to them that they are getting worse.  If there are orthopedic problems then those difficulties often get the first attention leaving the brain difficulties to take a back seat.  Complaints of brain related problems get referred to primary care or orthopedic doctors who may not be familiar with symptoms of post-concussive disorder and do not perform an adequate screening for loss of consciousness.

The individual I spoke with said he had flown about 10 feet at the time he was hit by a car.  So I asked him about his trip through the air and his landing.  He didn't recall them.  He recalled seeing the car approach him.  He recalled getting up from the ground and feeling disoriented.  It wasn't until I asked him about what happened that he came to the realization he had had a brief loss of consciousness.  Because he came to prior to emergency personnel being on scene he had not had an adequate evaluation for head injury. 

We discussed how he could communicate better with his health care providers and make use of support groups, technology, and rehabilitation systems as well as help with support for his family to better understand what had happened to him. 

The screening evaluation I provided him was just the first step in an overall evaluation that will point him in the direction of greater understanding of what happened to him and how he can best profit from rehabilitation efforts.