I'm sorry for your injuries; we all know what you're going through.

To answer your first question, a punch in the nose has more than enough force to cause a concussion. This is especially true in a brain that has suffered a previous injury. As you are exhibiting symptoms, it's a safe bet you've got another concussion.

I know it's frustrating, but traditional CAT scans and MRIs can't image the millions of tiny axons that get damaged and/or torn during a Traumatic Brain Injury (which is what a concussion is - and should be called). As a consequence, even people with profound cognitive deficits often have "clean" MRIs. There are more sophisticated scans that might image your injury, but they are very expensive. Besides, they can't really tell you how your damge is playing out in your daily functioning. For that, you're better off having a neuro-psychological exam.

As you've already discovered, your TBI doesn't like caffine. You need to avoid it and all alcohol and eat a healthy diet. It is also paramount that you rest. Exerting yourself mentally or physically at work, the gym or anywhere else will only make your recovery slower and less complete.

In your case, you need to be super careful because this is a second impact. Multiple impacts and cumulative injuries are serious. You are exhibiting symptoms that might indicate injury to several lobes (for example, behavior=frontal lobe, vision= occipital, etc...). When an injury extends to all area of the brain, it's termed diffuse.

Like you, my TBI causes me to suffer depression, anxiety, panic attacks, etc... Worst of all are the outbursts of temper. These are all signs of damage to your frontal lobe. I would advice you to find a psychologist experienced with brain injury patients to help with the depression, anger management techniques and general coping skills that might reduce your frustration level.

One of the best things you can do is educate yourself about your injury. Some excellent sources for further reading include: the Brain Injury Association of America (BIAA)www.biausa.org; www.tbiguide.com and our own TBI forum here on NT http://neurotalk.psychcentral.com/forum92.html If that's too much reading, there are a number of excellent Traumatic Brain Injury (TBI) videos on You Tube. (Who knew it wasn’t just idiots surfing on cars?)

Good Luck with your recovery.