Far too much of the focus in the study of what the researchers always call "mild" brain injury, is trying to predict how serious a brain injury will become, based upon the way in which the patient interacts with medical professionals in the acute stage. This misses the point. Certainly, if there was no concussion, there isn't likely to be a brain injury. But once there has been a concussion, the focus should not be on categorizing how serious the concussion was, but on what deficits the person is left with, after a healing period, and what we can do to minimize the disruption of those deficits upon this person's life.
Why do some people have apparent full recoveries, while others, are profoundly affected by a similar injury? To begin this discussion, we must summarize our theory of the pathology of subtle brain injury.
There is an overwhelming ignorance in the medical community that there is even the possibility of permanent brain injury in patients who may have suffered a concussion. To this day, a significant proportion of the medical community believes that there can be no permanent brain injury without a loss of consciousness or without a blow to the head. Perhaps more important, there is a poor understanding that brain injury symptoms may escalate after the first couple of hours. Likewise, there is far too much confidence put in our ability to rule out brain injury through the use of CT and MRI. This page will focus first on the diagnostic issues and then move on to the subtle symptomatology that underlies these types of brain injuries.
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