Brain injury is a major cause of death among people under 45 years. Many people suffer from mild to moderate injuries are not obviously injured and have to call external physical manifestations of injury to a few. In short, "look" good, despite the fact that they have suffered serious injury that can mean the loss of jobs, destruction of personal relationships and the fear that knowledge of all that accompanies themlost.
Survivors of mild to moderate traumatic brain injuries that are regularly carried out by doctors of their fatigue, inertia of thought and memory, reduced again, as they expect to recover from cuts, bruises and fractures. The all too common conviction is that time heals all wounds. For every rule there is an exception, and unfortunately, time heals all traumatic brain injuries. Over time, doctors destination address, the physical injury,but the head injury does not require special attention and TBI is not diagnosed. As a result, many patients suffered severe head injuries has never been a comprehensive evaluation by a neuropsychologist, including neuropsychological tests. Without examination by a neuropsychologist is not this injury is diagnosed, and these patients is never a proper care and treatment for their physical, cognitive, psychological, sexual and socialimpairments.Famili to obtain a complete copy of the medical records of survivors, including rescue and ambulance services, the emergency room and hospital records, if a license. A complete set is of fundamental importance, since all the detailed evaluations and objective measurements by paramedics, nurses and ER doctors and neurologists, who are required to understand the nature and scope made it clear that personal injuries.
Since the braingoverns our state and awareness, we can learn much about the extent of brain damage through the assessment of consciousness itself. If the level of consciousness different from normal, serious head injury, no matter what kind of a physical examination or other tests may indicate. The categories of disorders of consciousness are:
- Confusion The mildest form of altered consciousness, in which individuals are consistent thinking. Egmay not be able to solve a simple math problem or to recall what they ate for breakfast. Often seem disoriented and can not do much.
Stupor - at this level, people are often close to a coma and unresponsive to normal stimuli. It is only possible through intense and painful stimulation, as if they squeezed my toes or a blocked PIN be awakened. They can open their eyes, but only if they are forced to react vigorously.
Delirium - Thisintense altered state of consciousness is often the result of exposure to a toxic substance. People with delirium are confused, anxious, irritable and more responsive. You do not have an understanding of what he sees or hears, and are prone to visual hallucinations.
Coma - The most severe form of impaired consciousness, in which a person is completely unconscious and unresponsive to any type of stimuli.
Doctors use a system called the Glasgow Coma Scale (GCS)determined accurately describe the level of consciousness of the patient. To understand the severity of brain injury, is the condition of the patient at the first evaluation. The more severe the initial presentation, the most serious damage and the probability of a full and complete recovery is reduced. The scale is measured on three different responses of the eye, verbal and motor responses. Doctors consider the expression of a GCS score of limited overallInterest, what is most important is the score for each of the three categories of individuals. Each step of the reaction indicates the degree of brain damage.
The minimum value is 3 and there is no response from the patient. A person who is alert and oriented would be rated a 15.
The duration of unconsciousness is a red flag to rule out permanent damage to the brain, that is, the nature and extent of brain damage. Loss of consciousnessshould always be considered significant. However, there is a report of any loss of consciousness does not mean that brain damage has not occurred. Many head injuries over a long period of confusion with the spotty memory. E 'for patients are often asked what they remember after waking. More importantly, if constant, is taken constant reminder. In many cases, where there is no specific time leakage consciousness, do not restart a permanent storagelater for many hours or days.
The most common injuries to the brain is a quiet and hard to book. Called post-concussion syndrome, personal injury is often caused by seemingly innocuous injuries to the head. Individuals can receive a head injury, but did not lose consciousness and seem to do well. The difference between a post-concussion syndrome and traumatic brain injury is that the PC is temporary. TBI is not. Days or weeksLater, people have problems with memory, thought, experience of discernment, or they may simply feel "off" and not the same person as before the accident. These lesions are easily violated in the medical records of survivors reported, but it can also be seen by family, friends and associates who know that is not the survivor, "the same person" he / she is against this serious harm their body life has changed.
In today's world of shortMedical examinations, the doctors do not have the time, and in many cases, training with the patient about the specific changes in their ability to search for a head wound. Since many people improve over time, is the common form of reinsurance in medical care by a general practitioner or family doctor predicted. The result is that "denied relief," the treatment of the patient for failing to ensure a diagnosis honest.
Family members are the first to recognize the shortcomings and causes changesfrom a head wound, long before the patient is willing to admit the chronic deficits, but unfortunately this important information is not fully compatible with the doctors reported. It was also, by definition, a memory impaired person asking details of their cognitive loss is problematic. The question is the equivalent of a patient, "How long have been put out?" Once they have lost consciousness, not known, and rarely has anyone soon full consciousness. Come inside and outside the acuteAwareness is widespread. For the same reasons, calls for a memory-person reduced, I do not know what is more useful. And there is no clear boundary between depression, fatigue, irritability and memory loss from head trauma or other causes the product, even if these symptoms indicate a brain damaged patients. For this reason it is so important to follow a spouse, parent, brother or sister with a firsthand knowledge regarding the medical examinations.
After 3-6Months if there are gaps and improve more slowly than expected, the relationship the most important deficiencies in writing to the primary care provider and request a referral to a neuropsychologist.
In many cases, the lawyer for the surviving head injury, I, along with a detailed letter to the family of a doctor that the changes in the process of learning and communication skills, among others, supported by the patient and identified as a result have gained a ready referenceNeuropsychologist for evaluation and testing. Obtaining adequate medical care and treatment, especially for survivors of TBI, requires the assistance and support of family members, and often an attorney who knows and understands the signs and symptoms of brain injury.
A word of warning. Do not be deterred by the doctor fell on neuropsychological tests as a CT or MRI, no damage, ie, the images are seen aswithin normal limits.
First, CT can not be used to diagnose TBI, except in cases of serious fractures and contusions al. Secondly, the same goes for most of the MRI. If the MRI on a 3-T MRI machine, was created to disseminate sophisticated tensor images and fiber tracking software, is to be studied and interpreted by a neuroradiologist formats used in this protocol, the relationship of magnetic resonance is not definitive.
Note that an MRI using a T-3 in itself is notadequate supply of software, if diffuse tensor images and fiber analysis is used. This combination of hardware and software that enables professionals specially trained for the injuries of cut axons, and the other finished, otherwise invisible to MRI performed by T-1 or T-1 ,5-machines for identification. More importantly, MRI is not the first step in diagnosing brain injury. The accepted method for diagnosis of residual traumatic brain injury is testedassessed by a trained neuropsychologist TBI.
When you need to wait for a rally and to what extent? The general rules is that the shorter the time taken for the recovery, the greater the recovery. While everyone is different, patients tend to recover motor sensory and language skills faster and easier than writing and arithmetic skills, memory, attention, general intelligence and social / emotional balance. In addition to the recovery time longer, the loss of theseSkills and abilities are usually disastrous.
Motor and language recovery is usually within three to six months after the accident. Attention and memory are usually the most difficult to recover.
The pace of recovery is usually greatest during the first three months. Recovery tends to be on the budget for the first year slowly. This is one reason why it is valuable, a neuropsychological examination shortly after the head injuries suffered andTo understand with this basis of comparison with subsequent tests to determine the changes and the degree of improvement.
In general, it can occur after six months, some improvement, but usually is not significant. After that date, there is no cure in the traditional sense. Nerve cells in the brain and ways not regenerate. People can learn and do this to offset the damage from other skills and that's where the specialists of rehabilitation are very useful.
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