What Are Some Common Misconceptions and Misunderstandings People Have about Brain Injuries?
One misconception is that an injury to one area of the brain won’t impact other areas of the brain. The circuits, including degree of interconnectedness within the brain, are way too complex for there to be such discrete and isolated injury.
Another misconception is patients with mild traumatic brain injury all get better and if they don’t get better, then they are malingering. That’s totally untrue.
Another misconception is that if you have a CAT scan and an MRI shortly after you have been injured, and those studies are interpreted as “normal,” then you don’t have a brain injury. That’s also not true because of the limited sensitivity of CAT scan and a standard clinical MRI that’s done in most community hospitals.
Another misconception is that other diagnostic tests tell you something if they are interpreted as normal. An example of this is an EEG measuring brain waves and assessing for a seizure disorder that is interpreted as normal. A normal EEG cannot rule out a traumatic brain injury – it can only establish that there is no evidence of seizure activity. However, you can have a brain injury without seizure disorder.
Those are some of the predominant myths of traumatic brain injury.
What Are the Most Common Causes of Traumatic Brain Injury?
The two most common causes of TBI are motor vehicle accidents and falls.
Can a Brain Injury Occur if a Victim Does Not Lose Consciousness?
That’s another myth or old wives’ tale. Loss of consciousness is not a requirement for there to be a traumatic brain injury.
Closely related to the “busted” myth about loss of consciousness is the myth about amnesia. The theory was that there was a linear relationship between a period of amnesia (retrograde, that is, before the accident and anterograde, following the accident) and the severity of the outcome in terms of symptom burden. There are no adequate studies to document this claim.
Is It Always Necessary to Hit Your Head or Strike One’s Head to Cause a Traumatic Brain Injury?
Not at all. The skull, obviously, is made of bone. Inside the skull, it’s not all smooth; there are areas with sharp bony ridges. All that has to happen to cause damage to the brain on a cellular level is that there be enough sudden movement that the gelatin-like brain bounces around inside the skull, and even without sustaining a hematoma or identifiable hemorrhage, there can be microscopic injury to the structures within the brain, which include the white matter and grey matter structures. Such injuries can occur in whiplash type motor vehicle crashes or blast injuries.
Non-strike TBI can and do cause a mild form of traumatic brain injury, although the phrase “mild” is in large measure a misnomer for patients who experience persistent symptoms. The term “mild” really only relates to the length of loss of consciousness at the time of the injury. But for classification purposes, there is no linear relationship between the classification of TBI assigned at the outset of the injury and the outcome, although statistically, upwards of 80% of so-called mild TBI victims make a good recovery. However, if a patient experiences long term sequelae following a TBI and is assigned a diagnosis of post concussion syndrome lasting more than six months, the problems are greatly concerning and can be long-lasting and life-altering.
