Brain injury is a major cause of death in people under 45. many injuries sustained by the moderate, of course, can not be easily hurt and have some external physical manifestations of injury. In short, "they" look good, despite the fact that all suffered a serious injury to knowledge can mean the loss of employment, destruction of personal relationships and anxiety that accompaniesthat was lost.
Survivors of mild to moderate traumatic brain injury routine memory reassured by doctors in their slow recovery from fatigue, thought, and reduces them, as they expect broken bones to recover from cuts, bruises e. The all too common belief is that time heals all wounds. For every rule there is an exception and unfortunately time does not heal all traumatic brain injuries. Over time, doctors destination addressInjury, but head injuries do not receive the special needs physical attention and undiagnosed head injury. As a result, many patients with head injuries with permanent disability has never received a complete evaluation by a neuropsychologist, including neuropsychological testing. Without supervision of a neuropsychologist, accidents, this can not be diagnosed and these patients do not receive adequate care and treatment for their physical, cognitive, psychological,impairments.Famili sexual and social, a complete copy of the medical records of survivors, including emergency services and medical care, emergency room and hospital records, if a license. A complete set is crucial, because it contains all the detailed evaluations and objective measurements violations of paramedical staff, nurses and ER doctors and neurologists that they need to understand the nature and scope.
Sincethe brain regulates our state and level of consciousness, much has been learned about the extent of brain damage by the evaluation, if the level of consciousness is different from the normal, serious head injury, no matter what a physical examination or other evidence can. indicating the kinds of disturbances of consciousness are:
Confusion - The mildest form of disturbance of consciousness in which people have difficulty thinking,consistent. For example, they may not be able to solve a simple math problem or remember what they ate for breakfast. They often seem disoriented and can not speak much.
Wonder - At this level, individuals are often close to a coma and not responding to normal stimuli. It can only be triggered by intense or painful stimuli, as with their fingers crushed or stuck with a needle. You can open your eyes, but only if they have to respond forcefully.
Delirium - This intense 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 I see or hear, and are prone to visual hallucinations.
Coma - The most severe form of disturbance of consciousness, in which a person completely unconscious and responds to all types of stimuli.
Physicians use a system calledthe Glasgow Coma Scale (GCS) to clearly identify and describe the levels of patient awareness. To understand the severity of brain injury, patient condition in the initial evaluation is significant. Heavier than the first presentation, the most serious injuries and the probability of recovery is complete and the reduced. The scale is based on three individual responses measuring eye, verbal and motor responses. Doctors consider the expression of a GCS total score of limited interest, in particular, the score in each of three categories. Every step of the reaction shows 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 released in 15 years.
Any period of unconsciousness is a red flag to exclude permanent brain damage, ie, the brain assesses the nature and extent of> Accidents. Loss of consciousness is much to see. However, no report of loss of consciousness does not mean that the brain damage did not occur. Many head injuries result in a longer period of confusion with the spotty memory. E 'common for patients asked what you remember after waking. Even more important, learning, memory continues to be restarted. In many cases where there is no time lost specifically identifiedAwareness, memory continues not start for several hours or days later.
The most common type of brain damage is a quiet and hard-to-prehensive. Called post-concussion syndrome, the damage is most often through the head, which seems to be detrimental to the damage. Suffered a head injury to people, but never lost consciousness and seem to be quite good. The difference between a post-concussion syndrome and head trauma PCS is temporary. TBI is not. Days or weeks later, people have problems with memory, reasoning and decision, or may simply announce to feel "out" and not the same person they were before the accident. These lesions are not easily shown in the records injured survivors, doctors, friends but they are understood by family members, neighbors and employees who know that the survivors was "not the same person," have you been at this a result of serious> Injury changed their lives.
In today's world of short visits to physicians, doctors do not want the time and in many cases, training to ask the patient to change details on injuries in their ability to cope with his head. Since many people to improve over time, certain common form of medical care by a family doctor or general practitioner is provided. The result is that "calm" to the patient refuses treatment because it does not guarantee an honestDiagnosis.
Family members are the first to detect violations and deficiencies caused by a change in head, long before the patient is willing to admit that chronic deficit, but unfortunately the doctors important information not reported in full. person, also, by definition, impaired memory asking for details of their cognitive decline is problematic. And 'the equivalent of asking a patient, "How long was thrown out?" Once you lose consciousness, you do not know and rarelySomeone regain full consciousness immediately. Coming in and out of the acute awareness is widespread. For the same reasons it is required of a person with memory problems in what I do not remember, is not helpful. And there is a bright line between depression, fatigue, irritability and causes loss of memory caused by brain damage or other, although these patients have symptoms characteristic of brain injuries. That is why it is so important to the parents or siblings spouseto see first-hand knowledge examinations for medical monitoring.
After 3 to 6 months if the deficits persist or improvement is slower than expected, the main deficiencies noted in writing to the primary care provider and ask for a referral to a neuropsychologist.
In many cases, such as the attorney for the surviving head injury, I worked with members of the family ability to prepare a detailed letter to a doctor determines that the changes in learning and communicationsuffered, inter alia, by the patient and consequently received a reference to a neuropsychologist for evaluation and testing. Obtaining adequate medical care and treatment, especially for TBI survivors, needs the assistance and support of family and, often, an experienced lawyer who knows and understands the signs and symptoms of brain damage.
A word of caution. Get a doctor to fall in neuropsychological testing as a CT scan to be discouragedO MRI shows no lesions, that is, read the images in normal limits.
First, no, CT scans, the diagnosis of TBI, except in severe cases of fractures and bruises. Second, the same is true for most MRI. If the MRI was performed on a T-3 MRI machine to spread the sophisticated software tensor imaging and fiber tracking studies carried out and interpreted by a neuroradiologist in this protocol designed to provide the availability RMReport is not final.
Note that an MRI of a T-3 by itself is not sufficient if it is software that diffuse tensor images and fiber tracing. This combination of hardware and software that allows specially trained professionals to identify axonal shearing machines and other damage done, otherwise invisible magnetic resonance imaging performed on 1.5 T or T-1. More importantly, MRI is the first step in the diagnosis of brain damage. The accepted methodfor the detection of residues of traumatic brain injury test trained neuropsychologists evaluated by a head injury.
When a recovery is expected and to what extent? The general rule is that the shorter the time required for recovery, the recovery will be more complete. While each person is different, the patient's sensory, motor and language skills tend faster and easier than writing and math skills, memory, attention, the general recoveryIntelligence and social / emotional balance. In addition to the recovery time longer, the loss of these skills are usually more devastating.
Motor and language recovery is usually within three to six months of injury. Attention and memory are usually the most difficult to recover.
The pace of recovery is usually greatest in the first three months. Recovery then more slowly, the balance of the first year. This is one of the reasons whyvalue received neuropsychological assessment shortly after the head injury now and is the basis for comparison with subsequent changes to tests to measure and assess the scope for improvement.
Usually after six months, some improvement may occur, but usually is not significant. After that date, there is no cure in the classic sense. Damaged nerve cells in the brain can not regenerate and trains. People can and do learn to compensate for theirLesions with other skills and that is where the specialists of rehabilitation are very useful.
