I am sorry to hear of your daughters struggles.

You have had an interesting set of diagnostics. It is rare for an MRI to show any evidence of injury from a concussion. You must have a very specialized radiologist reading the films.

Don't over simplify the Visual Evoked Potentials. You said <visual evoked response (um...something like that...it's a test that measures communication between eyes and brain...showed a slower response than expected but only in the thousandths of a second).>

Those thousandths of a second can be a lifetime in brain cells that fire at up to 100 times per second. A five thousandths difference can be a slow down of 50%. This 'off timing' can interfere with the ability for the receiving brain cells to properly understand the information sent from the injured brain cells.

I have both a visual and auditory processing slow down, as much as 74%. My neurologist said that part of my brain is working at 25% power.

Life can appear to her to be going too fast. I dealt with this problem early in my recovery. There would be times when it appeared that the world was in hyper-speed. I have learned that I need to slow down my scan rate. I can't move my field of vision too fast or I will get confused. Also, I need to not look outside the car too close. If I stay focused on farther off objects, I do much better.

I do not drive except in rare quiet road situations. A rehab clinic tried to get me driving again. If there were not cars zooming past, I was able to tolerate the task. Once I got to a congested area where the cars and other objects were much closer to the car, I quickly overloaded. I was trying to drive in a normal passenger sedan. I notice that I do much better in large SUV's that have a higher seat height above the road. This gets me farther from the majority of the vehicles and other objects that are moving past my field of vision, especially the road markings.

Your daughter will likely benefit from learning to close her eyes at moments of confusion. Have her try listening for comprehension with her eyes closed. I bet it improves her listening comprehension.

I would advise being very conservative with the ImPACT Test. It does not test for the brain's ability to tolerate another impact. It is more useful at determining if the concussion symptoms will increase her risk of another impact due to poor reaction times, balance, and other mental performance issues.

If she is adamant about playing sports, try to get her to wear a Styrofoam helmet. Not one with a rigid plastic outer shell. They do not absorb the minor impacts as well. She needs a helmet that will deform easily. Her brain may be sensitive to very minor G forces that a hard shell helmet will transmit readily. There are some full coverage bicycle helmets that have a Styrofoam construction with only a thin flexible outer covering.

Her decompensation could have been from two reasons. She may have increased her pulse and blood pressure too high, or she may have just jogged her brain too much by the impact of her foot plant. I would suggest the latter was her cause.

An easy way to tell if the brain is receiving an impact from footsteps is to put in foam ear plugs. This will make the impacts very noticeable in the ears. There are some shoes that greatly reduce the impact from a foot plant. She can also try to learn a smoother running gait. But running should be a while off still. An elliptical machine does not have the impacting so it should be easier to tolerate.

She will need to be very careful with yoga. Positions where her head is lower that the rest of her body can be problematic. Learning to relax better will be good.

Regarding concentration and memory. Some of her memory issues are tied to her visual processing slowdown. It may help if she uses a multi-sensory approach to memory tasks. This means she sees, hears, and touches the information. See, Listen and/or repeat out loud, and write down. This creates more reference indexes for her brain to retrieve the information that was stored via the different sensory systems.

When she feels her mind wandering, mark her place and take a short break. It can be just a minute or much longer. Whatever she learns works best. You may be able to help her by observing her facial expressions. If you see her eyes start to dart around or look glassy eyed, she needs a break. I tend to close my eyes when I am getting overloaded.

There is a trick to reading with a visual problem. Try making a reading marker that is a piece of paper with a horizontal slit in it. It should show just one line of type, or maybe two. This reduces the other visual information from overloading her brain.

On the computer, she may be able to type out ideas on a blank Word document. It would be helpful if she wrote a journal of what she can remember from her past since the concussion. Noting her symptoms by date will help her see improvement.

You can also put such a journal together. Note what she has accomplished today that she struggled with yesterday. This is for a future reference or for doctors to see, not for her to use as a score card.

Also, try to minimize comments about how she used to be or how you hope she will recover. Believe me, she does not go a second without knowing these ideas internally. The best thing is to just be there for her as she needs you. If you can help her get some schedule to her day, that may help her feel normal. Just don't press the issue.

I get great value form my computer. I use it as my immediate and short term memory. I will forget what I am saying if I try to talk 'off the cuff." If I type out my thoughts, I can review what I just typed to refresh my memory of what I was saying. If I need to prepare to tell somebody something, such as a meeting with the doctor, it helps if I type out my thoughts first. As I edit and make my thoughts more understandable, I also make them more understandable to me.

Use a white board for her memory. I have one on the refrigerator. My wife will note something for me or sometimes I will remember to write down a note to myself. It needs to be in a place where I will see it routinely. I forget to look at notes in my pocket. If she has any habits of using a day timer, help her remember to put things down in it. My wife keeps her day timer for me. I have been able to develop enough skill to tell her to note a specific event. If I try to do it myself, I often will forget while I look for my note pad.

Have you downloaded and printed out Dr Glen Johnson's TBI Guide yet? It is at www.tbiguide.com It is the best reference available.

I hope this helps. If I have repeated myself from a different thread, that is just a symptom of my injury.

My best to you and your daughter.

Hugs