Mild Traumatic Brain Injuries – the injuries formerly known as concussions (Part 2)

In our last post, we discussed how “mild” traumatic brain injuries are not “mild” in the ordinary sense of the word.  Rather, using the word ‘mild’ means no anatomic damage but says nothing about the actual damage to the brain of these injuries.  So how do MBTI’s affect us immediately after a crash or injury?

At the scene of a crash, symptoms of brain injury can range from the severe (loss of consciousness) to the more subtle.  While all of us can recognize when someone is knocked out, what do the more subtle symptoms look like?  They can include a loss of memory of the crash or the moments leading up to it.  A lack of recognition of loved ones or ability to recall who to call for help.  Forgetfulness and repetitiveness, as in asking over and over again if a loved one has been called, even though told multiple times they are on their way.  These symptoms can occur even while the person is correctly answering other questions like their name, address and the like.

At the hospital, these symptoms are not always documented or, if noted, not well-documented.  This is because (generally) the emergency room is focused on immediate threats to health and safety.  Does the patient have broken bones?  A spinal injury?  A brain bleed?  Once these very urgent matters are ruled out, these more subtle symptoms may go unrecognized except by loved ones.  However, more and more hospitals are diagnosing head injuries and sending patients home with information about how to treat its immediate consequences.

In the immediate aftermath of a head injury, current advice includes limiting the brain’s activities.  How?  Let the brain rest.  No screens.  That includes phones, computers, ipads, you name it!  Lots of sleep.  Darkness.  No or reduced work.  If this sounds rather low-tech, it is.  Much like icing and resting a sprained ankle, our brains need rest to recuperate.

But wait – isn’t the rule you’re supposed to wake a person with a concussion every 2 hours?  It certainly used to be.  However, recent changes in treatments have led to allowing injured brains to sleep under many (if not most) circumstances.  Patients who are so unstable that they require monitoring every 2 hours are more likely now to be admitted to the hospital for full monitoring.  (Disclaimer:  Listen to your doctor, not a blog, on how to treat your specific situation.)

In our next segment, we will talk about what the longer-term effects of a brain injury can be and how they can be diagnosed or assessed (particularly in a legal setting).