I had my MRI done one month after my injury. Subsequent scans at 3 and 6 months showed the same damage -- it is all scar tissue/shrunken brain. I was getting into a van in the dark and thought I had clearance when I didn't. I hit my head going a normal speed for entering a car. I don't know the OP's history, but I know having an MRI done helped my treatment plan. Also, it was free with my insurance and may be with the OP's as far as I know. He should at least investigate.

Did the neuro mention whether the damage could have pre-existed your bump ? Atrophy usually takes longer than a single month to become evident. The fact that the atrophy was stable over the following MRI's suggest such a possibility. Could it be the impact just triggered a new level of symptoms after damage from a previous injury? We've had others on NT who had imaging that showed earlier damage even though they had no symptoms prior to the recent impact. .

I'm not confronting what you have said. Just wondering. I know that my last head impact was quite mild but my symptoms were worse than I have ever experienced from any previous head impacts. Plus, I never recovered from this last set of new symptoms compared to substantial recovery from prior impacts, including a moderately serious concussion 5 years previous.

I agree that there is value in accepting the injury and moving forward without the angst of trying to force recovery.

My MRI was done in a 3 Tesla.

Here are a couple quotes from the report.
"There is a single focus of blooming artifact in the mesial aspect of the left temporal lobe, at the level of the amygdala, not seen in the rest of the sequences. Given the patient's clinical history, this could represent a sequela of remote trauma / microbleed."

"Single nonspecific focus of T2 hyper signal in the subcortical white matter of the left frontal lobe."

This was the comment from my family doc:
"It looks like there is evidence to support an injury to the temporal lobe of your brain from head trauma. It probably will not be something that can be treated or 'fixed' easily, but at least it does confirm your symptoms and struggles."

My physiatrist and neurologist both looked at the images themselves and I had both of them review their notes in my medical file and help me write the simple(r) version of their notes below. (I have copies of their original notes somewhere too, but I cant seem to put my finger on them right now. Probably I put them somewhere "safe"... too safe for me to find!!)

Physiatrist: "The MRI images and report confirm this is not a simple concussion and post concussion syndrome, but a serious brain injury. Long term patient outcome less certain. Long term deficits are likely and should be expected."

Neurologist:
"MRI confirms serious brain injury. Patient recovery non existent in 2 years post injury. Future full recovery unlikely. Continue to manage visual symptoms and gait issues."

Starr

Starr,

What a report. You are fortunate to get a 3 T MRI. It does not look like your injury is limited to the microscopic level. As they say, maybe a bleed. Did you have any CT Scans done before this MRI showed your injury ?

I had a CT scan 6 months after my injury. It didn't really show anything... the report said something to the effect, "The CT scan is not negative, but no conclusive findings to report."

My doctors all agreed that either the scans were not clear or there was *something* there but no one was sure what they were seeing. Radiology recommended to redo the scan, but I declined. I was already a little freaked out about the radiation, I didn't want to do it a 2nd time.

Then 1.5 years after that, they did the MRI. I don't see my neurologist until September now, but I know at the last appointment he wanted to send me for another MRI to see if anything had changed. I expect he'll push for that again in September.

I know both my physiatrist and neurologist are particularly interested in seeing if there are any changes over time, both with the diagnostics and symptomatically. Apparently its so unusual to see *anything* on the MRI and still have the person be as functional as I am (I drive and run our now downsized hobby farm, with help). Never a good sign when your doctors find you interesting!

Starr

Are doctors amazing ? They make such uplifting comments. They seem to discount the ability of the human spirit. My neuro was amazed at my brain's severe dysfunction but was not surprised at my ability to function once he looked at how my intellect was still mostly intact. Our ability to work-around our supposed limits can amaze some doctors. They can even start to doubt the injury the tests reveal.

When my neuro saw how dysfunctional my auditory processing was, he responded "You hear everything. How do you handle that ? " My brain was not filtering out any auditory stimuli. It was overloading my system. He was amazed that I could function when there was conflicting audio stimulation. The 'bandwidth' of my sensory processing is 10 % of what a healthy brain's is. Two subsequent NPA's confirmed this.

Yeah Doc. Tell me about it. Been dealing with it for 15 years now. But, we learn to make do with our dysfunctions and try to move on. My biggest struggle is trying to listen to someone talk. I tend to get lost. I frequently use the back-up/rewind button on my DVR so I can re-listen to what was said. I wish I had a rewind button on the car radio.

I agree with not repeating the CT Scan with its high dose of radiation. Docs don't seem to care.

" Apparently its so unusual to see *anything* on the MRI and still have the person be as functional as I am " That fits with what I have read. Unless there are severe symptoms, an MRI is very unlikely to show any abnormalities that relate to the injury being investigated.

I'm glad to hear you are doing so well. You must have found the right cadence for the work load your brain can tolerate.

My best to you.

A second CT scan isn't a big deal as long as it's done at least 3 or 6 months apart, and the risk is pretty negligible, I think one CT scan is equivalent to a years worth of natural radiation. And for the risk to not be negligible you would need something like ten CT scans.

I worked this all out at some point because I am familiar with getting CT scans.

I remember a CT scan with and without color....Didn't show a thing....

Years later I had a PET scan....Dr. said " good news is we se nothing " After the explanation he was happy not to find any dead spots in my brain, and should think of it a positive and give me hope....