EsthersDoll,

It appears that your IICP was due to an increase in cerebrospinal fluid (CSF) since a spinal tap drain relieved the pressure. The more common issue is a brain bleed. Minor traumatic brain bleeds show up best at the third day. Later, and the brain usually has absorbed the blood. Earlier, and the blood has not pooled to an observable level. This would be similar to a ruptured aneurism but instead caused by the focused impact.

The axiom of not going to sleep for 12 to 18 hours or longer after a head trauma is to be able to maintain an observation of consciousness in case of a brain bleed. After 18 hours post trauma or longer depending on the source of information, the statistical likelihood of a brain bleed drops.

ICP can increase due to injuries that cause an increase in blood pressure due to a failure of the blood pressure regulating system in the brain, a brain bleed or a failure of the absorption mechanism that handles the overflow of CSF. The critical issue with ICCP is due to Second Impact Syndrome where the brain is impacted before the brain has had time to restore proper blood flow regulation. This can result in a catastrophic rise in intracranial blood pressure that ends up herniating the brain into the brain stem canal with fatal results.

Such increases in ICP especially those associated with high risk of further damage are associated with a severe increase in symptoms. The generic head ache or nausea is not usually associated with high risk.

An ambulatory person without disabling head aches or severe (over the toilet) nausea is rarely at risk.

The MRI may have noted an increase in ICP by noticing a decrease or increase in the fluid filled spaces in the brain. The sinus associated with drainage of CSF may have become engorged due to a failure to drain the CSF. A decrease in these spaces can be associated with abnormally high blood pressure in the brain as brain tissues swell.

Mark, thank you so much for your thoughts about what happened to me!

Unfortunately I did not experience headaches that I would consider "average" in any way shape or form when I had the iicp; they were debilitating to the point that even dilaudid administered through an IV in the ER could not take away my pain - it was truly awful. We assume that the level of pressure inside my skull rose in the cycle associated with it. (I'm sure you know people can live with that cycle for years depending on what level it starts at and how fast it increases until it becomes fatal.) I degraded so much that after six months I could hardly speak and I wasn't even able to maintain a minimal level of personal hygiene. It was a living nightmare. Which is another reason why I'm really trying to figure out more about what happened to me and why. You've really helped me to understand that it could have to do with the injured parts of my brain which I hadn't even considered before and may not have actually been from a bleed or swelling.

Luckily, I did not have a high enough level of CSF or IICP to herniate my brain to travel into the brain stem canal, but the Dr.'s wonder if it did cause further damage than the initial injury - however there is no way to tell and I'm still getting better.

Interestingly enough, when I was in the ER the first time, they told me that they allow people to sleep after head trauma - my boyfriend had tried to keep me awake during the whole ride there. And they recommended that I sleep when I felt like it and not to worry about it. They said that keeping people from sleeping is old school thinking and not recommended as much anymore.

I don't know much about MRI or EEG but the tone of this question reminds me of the confusion and lack of insight which I had at near the beginning of my recovery and the month or two after. I mean not being sure what is or isn't a symptom, thinking I was getting better or was going to get better very soon when I didn't really have any evidence for this and therefore trying to do things that I really shouldn't have.

Like you my symptoms took a week to kick in which just added to the confusion and lack of insight, since neither myself, those around me nor my General Practitioner had any idea that this could happen.

It particularly reminds me of being offered appointments with professionals and wondering whether I should accept them, since I was 'worried' I might be better by then and would therefore be inconveniencing them. The same attitude I think contributed to those around me not taking my injury seriously enough, since I kept implying that I was better than I really was, or that I would be better soon.

This was obviously a complete lack of insight on my part since I am still recovering after 10 months. Hopefully you'll be better well before then, but don't take it for granted and get all the help you can, from professionals, friends and family who need to understand from you that this is a serious and potentially long term injury.

Like I say this doesn't necessary include those particular tests, but the way you phrase things suggests you have a slight lack of insight which I recognise from my own experiences. Be careful, I found that over-optimistic, confused thinking like this was one of the symptoms of early PCS.

That said, many do get better in a relatively short time. Hope you're one of them!

EsthersDoll,

I would not be surprised if your symptoms are similar to chemo brain or the diffuse axonal injury common to concussion. Global injury even if the IICP was not at a dangerous level, can be frustrating since it mildly but consistently effects all of the brain functions. Any IICP will alter the blood perfusion. The lack of good oxygen levels and good removal of toxins released after metabolism can be problematic just like chemo brain.

All ramblings are allowed here. Welcome to Neuro Talk. I am sorry to hear of your accident, and the resulting issues. People who have had this occur will be here to answer some questions, and maybe direct you to another forum. If I were in you situation, and had the insuance of course, I would probably go ahead and have the tests done. It is my understanding that some of these brain injuries can give a person the type of trouble you are experiencing. I hope you can find resolution in the near future, and that your symptoms go away. I am glad you found this site. Lots of nice folks here. ginnie

My tone has a lot to do with the fact that no one really knows how to treat this. my primary care doctor didn't have a clue and the neurologist didn't seem to have a lot of knowledge about "head injuries". I just needed to make sure that I wasn't having test that were being performed just to appease me and my concerns to the doctor. I asked this question here, from people that are going through this, as a "second opinion" of sorts.

Sat. I felt great, did all sorts of things, thought I was going to heal quickly and on my way. Sun. through today=all the symptoms came back withour mercy. Somedays I feel with it, and other days, I have trouble finding words, spelling and other such activities. As stated, I do not want my neurologist to order test or think I am, one of those people that thinks they have everything ( sorry could not think of the word. Please fill in the blank when you read this.)
Thank you, I do value everyone's opinion, since you all have been through this.

TMQ,

You need to remember that your are injured. Just because you feel good does not mean your brain is ready for a busy day. Those busy days will be followed by a crash day or even two.

Learning to pace our days take time and serious discipline. You don't need to be paranoid about activities, just cautious to not get caught up with To Do Lists and other activities.

One of the best lessons learned by many of us with PCS is that much of the stresses of daily life are excessive. We can still be productive with a much lower stress and work load.

When you consider if you are going to submit to these tests and imaging, try to determine if the neuro is just taking shots in the dark. You can even be direct in asking him if he is. Many doctors tend to be that way when they can't understand your complaints.

You and your brain need rest and less stress. Doctors who cannot answer your questions should not be adding to you stress. It is very rare that the doctors can do anything different as a result of these tests.

If you have either, I predict you will need the next day or two to recover from the stress, especially the EEG. EEG's can be exhausting. Been there, done that, did not learn anything worthwhile.

So, maybe you should start keeping a journal. In it, list your activities and any sensations or brain fog. Include how you feel when you first wake up. Could you get right up and be aware of your day or did you need to sort of 'get your head together'? Even note what you are eating. Over time, you will start to see patterns. A busy day will be followed by a poor day, even if the busy day ended on a good note.

Time to go get dinner.

My best to you.

You're not a hypochondriac. (Is that the word you were looking for?)

What you are experiencing is real and like Mark said, it's just going to take you taking it easy in order for you to heal better and faster. Don't have a busy day for a long while. Slow down. I know it's difficult - trust me I know! But doing so will help you to get to having better days for longer periods of time.

I was also very disappointed when I learned that Dr.'s don't have any real treatments to help a person recover from a brain injury. But that's really what it boils down to. They are almost at a complete loss. And every brain injury is unique which makes it even more difficult to treat.


Mark In Idaho -

You're very correct in that I feel as if I have experienced a DAI because the impairments I've been dealing with have effected many areas of my brain and functioning. I don't know if the iicp is the sole reason aside from the concussion or if it just compounded the same effects of the concussion.

I didn't remember knowing what chemo brain is upon reading it here, if I've ever even heard of it before, but I just read about it and it's very similar to what I seem to be experiencing, except I might be experiencing something even more intense or drastic, I don't know enough to compare it. The good news is that I was much worse before now and I still intend to improve.

Thanks again!

that's the word-hypochondriac. Thanks. that's the hardest part. I try to talk to the children's parents- and words just don't come out.

Yeah, I totally understand. I work at a university and the people there are used to me being able to say the right words all the time, I used to be very articulate. Now, I have a lot of trouble remembering words and even lose track of what I'm saying mid-sentence.

I'm getting better. You will too!

I was seeing a speech therapist for months and one of the things she recommended for me to do so I could remember words better was to do crossword puzzles and I think it's helped tremendously. Just make sure if you do them, to not do them too much or you'll tucker yourself out and get worse. But do them when you feel like it.

That's what my Dr. told me again today - do what my body tells me to. (In reality I don't want to do what my body tells me to, I want it to do what my mind tells it to! )