I am a diffuse axonal injury patient. I had a fall with a horse over a jump and the horse connected with me in my right hand orbit and my brain was very knocked around, causing shearing of my brain tissue. It's coming up towards my annual anniversary. My neurologist has told me that I may take 5-10 years to recover from my injury, and that I am likely to have speech, balance and vision problems for the rest of my life.

I have been swimming and doing gym to try and improve myself. I must say that no matter how much my family tell me I have improved, it does not feel like it to me. My vision is not that good, though I must say I am getting better at coping with the double vision. There are times when I feel that my right hand side does not work, especially when I am swimming.

I know it's hard to answer me, but is there anyone out there that has had a similar injury, and continued to improved after a year has passed I would really appreciate your experience. Thanks

Nutkin,

I think you have been mislead with a diagnosis of Diffuse Axonal Injury. It is not a specific diagnosis but more of a catch all for a non-focal injury with the supposition that the injury is diffuse in that it is all over the brain. There are only a few very rare imaging systems that can image a DAI to the diagnostic point.

I think you have a focal injury with maybe some specific injury to your right orbit causing eye muscle dysfunction, maybe with nerves or muscles that control the eye being damaged. You also may have an undiagnosed upper neck injury as has been discussed in other threads. Your neuro's claim of 5 to 10 years to recover suggest to me that he is not very knowledgeable about your cluster of symptoms.

Have you been examined by a physiatrist (Physical Medicine and Rehabilitation) with a focus on your upper neck ? Have you been examined by an ophthalmologist or maxilofacial or facial reconstruction surgeon with special experience in the orbit's and the surrounding muscles' proper function ?

I would not give up trying to find a specialist who can tell you if there are other problems needing attention. From your exercise routine, you sound like you have the fortitude to persevere to find some more answers.

Are your speech problems due to oral coordination or due to speech processing issues inside the brain ? Or are they word finding or getting the right words to come out of your mouth ? I know people with just about every brain injury caused speech disorder. Most are able to do amazing things beyond the perceived limits of their speaking abilities. Your posts suggest you are a very capable person. You should feel encouraged.

Keep up the fight to find answers. I would bet good money that there are still things that can be done top help you improve. My experience at recovery from many concussion set-backs tells me that there is always more to come. Many of my improvements have not been physical healing but rather skill development at working within my limitations.

My best to you.

Hi mark. Thanks so much for replying. I think my voice is due to my brain as if I talk slowly and I really concentrate on what I'm saying, my voice sounds much better. I am very fortunate that I don't have any deep scarring on my face. Most of the damage to my brain seems to have been the shearing of tissue, and the clots that formed. I had about five clots in the temporal lobe, and on the left hand side at the back and front.

When I go to South Africa next month I am going to see my neurosurgeon that treated me initially, and hope he can give me some more info on my recovery. I know I have beaten all odds as he had originally thought I would not walk for maybe three years.

The one thing I am is very determined to better myself, and I am very lucky that my thinking brain has not been injured long term. Anything I undertake has to be competitive, which is why I am going to SA to swim in the Midmar mile race. I will enter the disabled section, and although I am not very fast, I aim to finish!

I will write again when I have done the race and let you know how I do. Thanks for your support. Cheers. Debs

nutkin,

I suggest you try relaxing as you talk. Take a few breaths while gathering your thoughts then speak them. I often have to rehearse what I am going to say. I would not be surprised if your struggle is similar. If you rehearse your comments, even if only briefly, your brain does not need to process the conscious thinking and process the speaking at the same time.

Often, we brain injured can only do one thing at a time. We can think or speak. We may struggle to think and speak simultaneously. So, try breaking up the two processes. You will find your rehearsing give you a chance to speak more concisely and understandably too.

The shearing of tissue and related clots you experienced are generally focal injuries. Often, as the brain is bounced around inside the skull, nerve and vascular tissue can get torn as it grates against the bony protuberances inside the skull. The inside of the skull is quite rough. You probably had a sizable twisting of your head during the accident. This can cause such damage. It can also cause injuries to the upper neck.

Ask the neurosurgeon about your upper neck. Tell him that studies have shown that a high percentage of head injury symptoms can be attributed to upper neck injuries. He may be able to order a set of images of your upper neck to see if you have unresolved issues. These unresolved injuries could be the cause of your right side weakness.

My best to you.

My speech was very messed up for a long time.

People recommended that I try to relax too. It didn't help - it didn't matter how relaxed I was - my speech was messed up.

Until I started taking hormones. The concussion I suffered from damaged my pituitary gland and I now need to take supplemental hormones. Since I started taking hormones my speech and voice have improved a great deal. They are almost back to normal now!

The last time I saw the specialist who is treating me, he said he has another head injury patient, like me, who's voice and speech improved after taking hormones for a few months.

I've read this same account from a few other websites about other mTBI patients as well.

Some experts think that some or many cases of PCS are actually caused by hormonal imbalances triggered by the physical insult to the head/brain. Most of these cases of hormonal imbalances correct themselves within the first year after the injury.

The pituitary gland and its stalk are both vulnerable during concussion because they are located in a delicate spot in the skull called the sella turcica below the brain.

I realize that this isn't the case for everyone, and that anxiety can cause some speech impediments or changes for some people. And some focal injuries can also affect the voice and speech.

But in addition to my voice and speech improving, since I started taking the hormones, my ability to do more than one thing at a time has improved.

Everything has improved!

People need hormones to function in the world. Healthy people take them for granted until they aren't there. There are many different hormones that everyone needs.

Hormone production is triggered by chemicals that the brain produces. Some hormones are triggered by an area of the brain and produced by a another part of the body. Some hormones are produced in the brain itself. And some are triggered for production by one area of the brain and then produced by another area of the brain.

One well-known example of a hormone that people need is Insulin. Diabetics don't produce insulin and so they need to take it supplementally in order to function.

But it's all interrelated.

Growth hormone is usually the first hormone to "go" after a concussion that causes hormonal imbalance or dysfunction. Growth hormone deficiency can cause physical and cognitive dysfunction. An mTBI patient who is suspected of having growth hormone deficiency (GHD) might be injected with glucagon to test for GHD. And Glucagon has the opposite effect of insulin. They might also be given an ITT, an insulin tolerance test to prove or disprove GHD.

Before the accident I was in, I was a super-tasker. (I have many sworn witnesses! I used to work in the very fast-paced environment of live entertainment.) I'm not there yet, and I may never be again, but it feels so much better to be able to deal with a restaurant atmosphere again since my filtering process has also improved.

It's been 3.5 years for me and I'm taking 3 different hormones now and I'm doing significantly better! The expert I'm seeing says it may take about a year for my hormone replacement treatment to fully take effect and I'm still improving!

Hang in there.

Most damage caused by a concussion seems to be resolved within the first year, even hormonal damage. No matter what the actual cause of it may be, you'll probably continue to see improvements for years to come!