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Brain Injuries are Not All the Same

Brain Injuries Are Not All the Same and not every person with an illness faces the same symptoms and challenges as the person next to them. The conditions listed below are general symptoms of each condition and are not applicable to every person and their specific journey.

Traumatic Brain Injury occurs with external mechanical force causes various brain dysfunction usually occurring from violent blows to the head or body. This can occur in consistent or inconsistent patterns in many hits or singular hits that occurred over time. Traumatic brain injury can cause temporary dysfunction of brain cells and more serious version of traumatic brain injury can result in brain bruising, torn tissues, bleeding and other physical damages.

There is a wide range of symptoms with physical and psychological effects that can appear immediately after a traumatic event or days and weeks later. There is no consistent timeline in when these symptoms can occur and in what form they come. There are three levels of brain injury in being mild, moderate and severe and the symptoms vary in these stages.

Mild Traumatic Brain Injury – Symptom Overview

General Physical Symptoms

  • Loss of consciousness for seconds to minutes
  • No loss of consciousness but resulting in dazed, confused or disoriented states
  • Headaches
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Difficulty sleeping
  • Sleeping more than average
  • Dizziness and or loss of balance

Sensory Symptoms can range from:

  • Blurred vision
  • Ringing in the ears
  • Ongoing bad taste in mouth
  • Changes in ability to smell
  • Sensitivity to light or sound

Cognitive or Mental Symptoms:

  • Memory or concentration focus problems
  • Mood changes or swings
  • Depression or anxiety

Moderate to Severe Traumatic Brain Injury – Symptom Overview

General Physical Symptoms:

  • Loss of consciousness from several minutes to hours
  • Persistent headache that worsen over time
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Dilation of one or both pupils of the eyes
  • Clear fluids draining from nose or ears
  • Inability to waken from sleep
  • Weakness or numbness in fingers and toes
  • Loss of coordination

Cognitive or Mental Symptoms:

  • Profound confusion
  • Agitation, combativeness or other unusual behavior
  • Slurred speech
  • Coma and other disorders of consciousness

Traumatic Brain injuries can occur in any of the following sub categories:

  1. Falls: out of bed, slipping in the bath (tub, shower, floor), falling down steps, falling from ladders or heights where brain or head injury can occur
  2. Vehicle Related: car collisions including motorcycles, bicycles, pedestrians
  3. Violence: Approximately 20% of traumatic brain injury can occur through violent acts such as: gunshot, domestic violence and or child abuse. An example of child abuse traumatic injury is shaken baby syndrome.
  4. Sports Injuries can include a number of sports: soccer, boxing, football, baseball, lacrosse, skateboarding, hockey, and any high impact or extreme sporting
  5. Explosive blasts/Combat injuries/Military Impact: explosive blasts in active military duty all the way down to mechanic damages with pressure wave technologies than can connect and pass through the brain. Penetrating wounds, severe blows to the head with debris and falls with bodily collisions.

Chronic Traumatic Encephalopathy is a progressive neurodegenerative disease of the brain that is commonly found in athletes but also can occur in non-athletes. It is a repetitive brain trauma that can include symptomatic concussions as well as sub concussive hits to the head. The trauma of the hits triggers progressive degeneration of the brain tissues in an abnormal protein called tau. The changes in the brain can begin months, years or even decades after the final brain trauma occurs. The symptoms associated with CTE on a general level include memory loss, confusion, impaired judgement, impulse control problems, aggression, depression and can eventually lead to progressive dementia and or Alzheimer’s in some cases. Symptoms vary person to person and a person can develop and react different to each symptom. There is no guarantee in developing every symptom and the progression of the condition is based on each individual. CTE is not determined in validity of diagnosis while the person is still alive. The determination of diagnosis is only available postmortem thus far.

CTE can progress in two patterns of younger and old people. In younger people it may begin with behavior and mood changes. In older people it may begin with cognitive problems that can ultimately progress to dementia. The

General Symptoms of CTE

  • General Symptoms of CTE that are researched based to begin eight to ten years after the repetitive traumatic injury:
  • Difficulty thinking (Cognitive Impairment)
  • Impulsive behavior
  • Depression and or apathy
  • Short term memory loss
  • Difficulty planning and carrying out tasks (Executive Function)
  • Emotional Instability
  • Substance Abuse
  • Suicidal thoughts and or behaviors
  • Irritability
  • Aggression
  • Speech and language difficulties
  • Motor impairment to include but not limited to the following: difficulty in walking, tremors, loss of muscle movement, weakness and rigidity
  • Trouble swallowing (Dysphagia)
  • Vision and focus problems
  • Trouble with sense of smell
  • Dementia

CTE is generalized in stages of progression of symptoms:

  • Stage One: Headache, loss of attention and concentration
  • Stage Two: Depression, explosivity and short term loss
  • Stage Three: Decision-making (executive dysfunction and cognitive impairment
  • Stage Four: Dementia, word finding difficulty and aggressive

Mild Cognitive Impairment can also be referred to as Incipient Dementia and or Isolated Memory Impairment that is an intermediate stage involving early onset of cognitive impairments beyond what would occur in expected age and education. It can involve problems with memory, language, thinking and judgement that are beyond normal age related challenges. There is no single cause related to MCI or a definitive outcome to MCI. Progression of the disease can take place for years and in some cases progress to Alzheimer’s or other forms of dementia and is also noted in some cases to improve over time.

General MCI Symptom Overview

  • Forgetting things more often
  • Forgetting important events to include social engagements or appointments
  • Losing your train of thought or thread conversations when talking to others
  • Feeling increasingly overwhelmed by decision making, planning and processing steps to accomplish a task or interpret instructions
  • Can start to have trouble finding and navigating around familiar environments
  • Can become more impulsive or begin to show increasingly poor judgement
  • Depression
  • Irritability and aggression
  • Anxiety
  • Apathy

A concussion is a version of a traumatic brain injury that can alter and effect the way your brain functions. Violent blows or hits to your head, neck and or upper body can cause your brain to slide back and forth forcefully knocking against the walls of your skull. The effects can be temporary and include headaches, problems with concentration, memory, balance and coordination. Concussions and commonly known to occur with hits to the head but also violent shakes to the body. Concussions need time and rest to heal properly with appropriate medical care and usually result in full recovery.

Symptom Overview

  • Signs and Symptoms can be subtle and occur over time and last for various stages of time to include the following:
  • Headache or pressure feeling
  • Loss of memory (amnesia) and confusion
  • Confusion or feeling in a “fog”
  • Dizziness or “star seeing”
  • Ringing in the ears
  • Nausea and or vomiting
  • Slurred speech
  • Delayed responses
  • Appearing dazed
  • Fatigue
  • Concentration and or memory complaints
  • Irritability and other personality changes
  • Sensitivity to light and noise
  • Sleep disturbances
  • Psychological adjustment problems and depression
  • Disorders and differences in taste and smell

Sub Impact hits are defined as continued hits to the head with intense or frequent occurrences to weight bearing joints. These can include foot, knee, head and hips that occur in high impact settings. Sub impact hits can have influence over cognitive functioning across a person’s life span. There is no defined time that the body can react and produce symptoms from the occurrences of sub impact hits. Sub impacts are the most commonly known as frequent and impactful hits on a consistent basis of time or in a short time span of consistency.

  • Executive Function is the mental process that enables one to plan, focus attention, remember instructions and complete multitasking items. When the brain is deficient in these skills, it becomes difficult for the brain to filter out distractions, prioritize tasks, achieve goals and focus on time management needs.
  • Executive Function depends on three types of brain functions that work together when the process is flowing correctly:
    • Working Memory= controls our ability to retain and manipulate information in short time periods
    • Mental Flexibility= helps keep or shift focus and attention in response to different demands, rules and environmental settings
    • Self-Control= enables the mind to prioritize and resist impulsive actions or responses
  • If a person with Executive Function issues do not get what they need from their relationships or conditions through their environment it will worsen the person’s mental ability. An example of this could be toxic stress that can cause serious delay and impairment. Adverse environments resulting from neglect, abuse, and/or violence that has been exposed to toxic stress can disrupt the brain and continually impairs the executive functioning abilities.
  • Adults with executive function issues can facilitate positive development by establishing routines, modeling social behavior, creating and maintaining supportive and trusting relationships
    (NOTED FROM CENTER OF THE DEVELOPING CHILD AT HARVARD UNIVERSITY)