Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 07-15-2010, 07:10 AM #1
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Default Diffuse Brain Injury

hi all

I have just received my scans reports ECT
my LOC was not recorded at the A&E and I was sent to another hospital 30 miles away for the CT of my head at 3am with my wife and young child

this took the form of a letter put into my pocket that my wife found in the morning


I did not receive a CT brain scan until 8 days after my injury? I had CT of my bones the next day, but was sent home, to wait for surgery for 7 days being Christmas and all, in the intervening days I developed a CSF leak from my nose

now my question is

would brain swelling show up 8 days after would damage show up also

diffused injury is only indicated by swelling Yes ??

nuro psych assessment says I have an ABI

Yeah I know that and so do those who new me before and now

So is nuro psych assessment the only way to diagnose
diffused brain injury

with no record of LOC

at the time I thought I was 3 days ago, eg missing 3 days this lasted for 24 hrs

and then could not remember a 2hrs before and 3 hrs after for 3 months and still only fragments

this is termed PTA post traumatic amnesia


is there other tests that show diffused injury , not that it will make any difference 2 years 7 months later

thanks for reading and for any input you may wish to add

http://www.brain-injury-online.com/d...in-injury.html
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Old 07-15-2010, 02:42 PM #2
Mark in Idaho Mark in Idaho is offline
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Vini,

I am a bit confused. What is ECT?

There are some imaging systems that can show Diffuse Axonal Injury but they need to be high quality images and closer to the injury date from what I understand. High Tesla MRI (6 Tesla and higher) can show minute damage. fMRI (functional MRI) can show if parts of the brain are not functioning normally. DTI (Diffuse Tensor Imaging or Diffused MRI) can also show problems. It is probably the highest technical image available.

There is not necessarily observable/imageable brain swelling from a DAI. It would likely require a baseline CT or MRI to show minor brain swelling. They have to look at the fluid margins around and between lobes or midline shift if the swelling is one hemisphere only. This is difficult without a baseline if the difference is minor.

Swelling will be more likely if there is a Second Impact (Syndrome) and/or extensive brain disruption/LOC. Brain bleeds show up best at about three days post injury with a CT. High Tesla MRI will show axonal injury immediately. Most MRI's are 1 to 1.5 Tesla, not the 6 Tesla and higher needed to show microscopic injury.

A neuro-psych assessment is more helpful because it validates the dysfunctions you are having. The others just tell you about the anatomy and physiology. There is not always a direct line between the anatomy/physiology and symptoms. Neuro-psych diagnoses symptoms.

A neuro-psych assessment can be variable depending on the battery of tests done. Some neuro-psychs have a bias against brain damage (mTBI) especially if there was no LOC. They are stuck in old and bad science.

An important issue to look at is the differential between different tests. If WAIS-II Intelligence scores are high but Wechsler Memory scores are very low, this is likely indicative of organic injury. If Trail Making Test A is in the low end of the normal range but Trail B is at the high end, this is a good indicator. It shows a difficulty with switching, a PCS symptom. The MMPI-II can point to depression if not read with a mTBI in mind. There is an overlap between depression and mTBI with the MMPI-II. The subject may also have depression and mTBI to confuse the NP doc.

Many neuro-psychs just look at the normal range without the comparison between tests. This can lead to a diagnosis of psychological or psychiatric problems, malingering, depression, somatoform, etc.

I have had two N-P assessments. Both indicated mTBI but both neuro-psychs diagnosed depression. They even commented that the depression scales showed no depression but they still believed my symptoms were depression caused.

There are validity tests done to check for effort and faking/malingering. I passed with flying colors but they still discounted my effort and the tests validity.

So, vini, you are stuck in the middle of the road with the rest of us. We all have to dodge the oncoming cars ( bad diagnosis) while trying to get help. The system wants to dismiss us but we know better.

Good luck.

My best to you.
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Last edited by Mark in Idaho; 07-16-2010 at 11:39 AM.
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Old 07-16-2010, 05:14 AM #3
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Default hi

thanks mark your a treasure

Et cetera (in English contexts pronounced /ɛt ˈsɛtərə/) is a Latin expression that means "and other things", or "and so forth" sorry mate brit expression

with no LOC data could have been 30min to an hr I have no idea. but new thinking relates to the period of change of conciseness and post traumatic amnesia as a point of reference as opposed to the Glasgow come scale

my nuro psychologist understands its the less informed that P me off with there depression crap and insist of prescribing powerful drugs to fit there diagnosis

or supposed trained cares ,I will call babysitters , that cant understand loss of executive function slow processing but intact IQ that is above their own, and base their judgments. on limited knowledge

its just plain arrogance


take this example I have cronic daily head aches migraine, eye pain , and taste salty fluid running down the back of my throat

see attached image of the back of my eye socket post opp and behind the titanium plates , note the hole and fluid draining into my maxilla sinus

babysitters says !! put you glasses on

GP says your depressed and the medication I have put you on can cause change in taste ? but I say hang on I had this before

GP I,ll up the dose
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