[confuused905]

So I had my first visit to the neurologist today. I suffered a mTBI after an assault on May 27, 2011. I checked a couple of doctor ratings website and he was highly rated. He was a genuinely nice person who listened to all I had to say.

I asked him about concussions being a mild type of diffuse axonal injury and whether this could be permanent. His response "NO. If that were the case we'd have a bunch of people walking around with DAI and severe brain trauma. You only get DAI from such instances as getting thrown out of a windshield".

I pressed the issue and told him that there could be microscopic damage. He said something like 'trust me, if there were damage a coroner would find it'.

I asked him whether or not my injury would have permanent effects. He said there was pretty much a zero percent chance of this and at my age I should recover just fine. Most people in general recover just fine from mTBI. He said all my symptoms are normal and I should be back to 100% at the six month mark. Currently I am feeling almost like my old self again @ the 4 month mark.

He mentioned that the people who have lingering issues usually have ongoing litigation or something else for personal gain.

We also talked about Sidney Crosby. I told him that Sid only suffered two concussions and he laughed. According to him, Crosby has probably suffered a LOT more concussions in his lifetime.

He said if I'm still worried, he can arrange for neuro-psych testing. However, its $2400 and not covered by OHIP. I politely declined. He said that was a wise idea since I didn't need it.

All in all, he didn't tell me anything new or mind-blowing. But it felt good to see a neurologist.

[roadrunner63]

I'm concerned about him not thinking mTBI having permanent effects. This was my first concussion and I have permanent effects. Doctors said I'd be back to normal in one month, then 3 months, then 6 months, then there's a possibility of it being permanent.

And those permanent effects are proved by the neuro-psych test. I would advise anyone with a concussion to have neuro-psych test asap.

[Mark in Idaho]

confused,

That neuro is a head case. His understanding of concussion and DAI is non-existent. Not uncommon for a run of the mill neurologist.

Most neuros are best at brain issues that show up on an MRI/CT or EEG. They struggle to accept any brain condition that is not imageable.

Your ongoing symptoms should determine what course you choose to follow. Problems with memory, executive functioning and such should be the reason for a NP Assessment.

If you are feeling like you are almost back to normal, be grateful and go on. Just remember to try to limit the risk of future head impacts from sports or other activities.

[rick92]

[QUOTE=confuused905;808172]He mentioned that the people who have lingering issues usually have ongoing litigation or something else for personal gain.

QUOTE]

i probably would have punched him if he told me that. what personal gain can you get from feeling miserable

[confuused905]

[QUOTE=rick92;808552]

Originally Posted by confuused905

He mentioned that the people who have lingering issues usually have ongoing litigation or something else for personal gain.

QUOTE]

i probably would have punched him if he told me that. what personal gain can you get from feeling miserable

I totally agree. Truth be told, there are some humans who are evil enough to exaggerate their symptoms for money. But the majority who suffer w/ pcs are just normal people battling a terrible illness who probably would give up a fortune just to feel like their old selves again.

[confuused905]

Originally Posted by Mark in Idaho

confused,

That neuro is a head case. His understanding of concussion and DAI is non-existent. Not uncommon for a run of the mill neurologist.

Most neuros are best at brain issues that show up on an MRI/CT or EEG. They struggle to accept any brain condition that is not imageable.

Your ongoing symptoms should determine what course you choose to follow. Problems with memory, executive functioning and such should be the reason for a NP Assessment.

If you are feeling like you are almost back to normal, be grateful and go on. Just remember to try to limit the risk of future head impacts from sports or other activities.

Yep, I totally agree w/ concussions involving mild DAI. After all, it just makes sense when you think of the physiology of a concussion and the differing densities of grey and white matter.

I am interested in neuro psych testing, but being a broke student I'll have to put that off until a future date. Most of my physical symptoms have cleared up, but I still notice subtle inconsistencies with my old self in areas of memory and other cognitive functions.

My hope is that I'm at least back to 97% in a year's time. I pretty much know its impossible to get back to 100%. After all, a dead neuron is a dead neuron. There's no regeneration, at least very minimal regeneration.

[Bright&Dark86]

Yea, that neurologist sounds like a cocky jerk. Seems like he didn't really answered any of your questions. That's gotta be frustrating. I'm sorry that happened to you.

The neurologist I saw after my first concussion was like that too. She told me I didn't actually have a concussion because I never lost consciousness. I understand that years ago that is how the medical world categorized head injuries. This was 2009 though and not the 80's. The definitions of concussion and "head injury" have changed a little since then. She also said that my symptoms were all psychological in nature and that I needed to be on antidepressants to treat my mental illness. I felt like I was completely being dismissed as a crazy person. Soon after that visit I changed doctors and am much happier with the people treating me now.

I would recommend following up with your primary care physician and sharing with him/her what the neurologist said to you. Maybe they'll suggest seeing someone else?

[Klaus]

He mentioned that the people who have lingering issues usually have ongoing litigation or something else for personal gain.

I have read a few very good evidence-based articles which do mention this as a statistical contributary factor to worse reported symptoms (among many other things). This does make sense I guess, but none of them say that all lingering symptoms are linked to such issues, far from it.

For him to suggest that they are is extremely insensitive and ignorant. It also makes it seem as though if you do get any more problems (hopefully you won't) then you won't get any useful help from this guy, however nice he may seem. He doesn't believe that the problems you might have exist, because he is not doing his job properly and not making any attempt to keep up to date with the evidence.

[Mark in Idaho]

The pending litigation and other personal gain issue has been widely promoted by both health care insurance companies and liability insurance companies. They have been wagging the tail of concussion research for decades.

They have stopped the use of qEEG's to validate brain injuries. One neurologist's negative article published in a 'peer' reviewed journal killed the qEEG for diagnosing and substantiating a mTBI or PCS.

While litigation can be a factor, it does not factor in when the subject is still symptomatic after an extended period of time. Plus, a decent Neuro-Psych Assessment such as the Halstead Reitan Battery includes validating tests that weed out malingerers. But, even with high scores for validity, NP's and others will still try to claim malingering.

For example, in my first NP Assessment, I scored 48 and 49 out of 50 on the validity tests. 50 is a perfect score of no malingering. Malingering subjects usually score in the mid to low 30's. The NP defied the high scores and claimed I was malingering. Odd that 5 years later, I scored the same low scales for memory and other cognitive dysfunctions with a NPA administered by a different NP.

Neuro's may claim malingering because they do not have any other worthwhile ideas. If they can not diagnose the concussion, it must have not happened.