Decades-old head injury. What now?
December 7, 2012 4:28 AM Subscribe
Tell me about the long-term effects and detectability of decades-old head injuries.
Twenty-odd years ago, when I was about ten years old, a summer camp mishap knocked me to the ground and I hit my head so hard that I lost consciousness. I don't know how long I was out, but it was long enough for people to gather around and stare down at me worriedly. In hindsight, I probably should have been rushed to the hospital, but these were simpler times, and the injury was never treated or followed up on in any way.
So what now? Obviously it didn't kill me, but I wonder about the long-term effects. What could it have done to me? Are there any tests that could be performed now? Is anything still detectable after all these years?
Twenty-odd years ago, when I was about ten years old, a summer camp mishap knocked me to the ground and I hit my head so hard that I lost consciousness. I don't know how long I was out, but it was long enough for people to gather around and stare down at me worriedly. In hindsight, I probably should have been rushed to the hospital, but these were simpler times, and the injury was never treated or followed up on in any way.
So what now? Obviously it didn't kill me, but I wonder about the long-term effects. What could it have done to me? Are there any tests that could be performed now? Is anything still detectable after all these years?
Best answer: Any head injury with a loss of consciousness is considered, at least, a mild traumatic brain injury (mTBI). I doubt what happened to you was anything more severe than that; it sounds like you were likely unconscious for less than 30 minutes, and you don't mention any amnesia surrounding the event.
There are tests that can be done after TBI that are useful in determining the extent of damage, but I strongly doubt they could detect anything in your case, given that it occurred twenty years ago and you were young at the time. The brains of young people are still growing and are highly plastic, which means they have substantially greater ability to recover from brain injury compared to adults.
My one caveat is that brain injury appears to be cumulative. That means that repeated injuries over time can cause progressive damage, even if each insult was relatively mild. Thus, boxers and football players have substantially elevated risk for cognitive impairment, dementia, and all kinds of TBI-related nastiness, especially as they age. But one mTBI when you were young is probably nothing to worry about.
posted by dephlogisticated at 5:00 AM on December 7, 2012 [2 favorites]
There are tests that can be done after TBI that are useful in determining the extent of damage, but I strongly doubt they could detect anything in your case, given that it occurred twenty years ago and you were young at the time. The brains of young people are still growing and are highly plastic, which means they have substantially greater ability to recover from brain injury compared to adults.
My one caveat is that brain injury appears to be cumulative. That means that repeated injuries over time can cause progressive damage, even if each insult was relatively mild. Thus, boxers and football players have substantially elevated risk for cognitive impairment, dementia, and all kinds of TBI-related nastiness, especially as they age. But one mTBI when you were young is probably nothing to worry about.
posted by dephlogisticated at 5:00 AM on December 7, 2012 [2 favorites]
I agree with both of the above posters. A good resource online is here: bia. They have quizzes and articles and all kinds of stuff for scaring the pants off of you. But based on what you've reported, I would be surprised at any long term consequences based on the one injury.
But with good reason; it is the cumulative effects that will get you. Even if you aren't a pro-sporter or an avid amateur, once you've had one, or two, or twelve (ask me how I know!) it's more likely to happen again, especially immediately afterwards (or somewhat). If you haven't, well, good!
Additionally, some of the symptoms of concussion (memory loss and zoning out), feed on, contribute to, can be contributed by to depression. So if you are experiencing some issues, it helps to have a look at a depression option/treatment.
So, are there any symptoms at this time that worry you in yourself.
posted by tilde at 6:05 AM on December 7, 2012
But with good reason; it is the cumulative effects that will get you. Even if you aren't a pro-sporter or an avid amateur, once you've had one, or two, or twelve (ask me how I know!) it's more likely to happen again, especially immediately afterwards (or somewhat). If you haven't, well, good!
Additionally, some of the symptoms of concussion (memory loss and zoning out), feed on, contribute to, can be contributed by to depression. So if you are experiencing some issues, it helps to have a look at a depression option/treatment.
So, are there any symptoms at this time that worry you in yourself.
posted by tilde at 6:05 AM on December 7, 2012
Childhood brain injury is quite a complex thing because if you did have any long term effects, they would have interacted with your normal development to look quite different now. It's a notoriously difficult thing to predict the long term effects.
I would guess it would be extremely difficult for a psychologist to make a statement one way or the other at this point, though a radiologist would probably be able to look at a brain scan and tell you whether there is any visible damage.
posted by kadia_a at 9:45 AM on December 7, 2012
I would guess it would be extremely difficult for a psychologist to make a statement one way or the other at this point, though a radiologist would probably be able to look at a brain scan and tell you whether there is any visible damage.
posted by kadia_a at 9:45 AM on December 7, 2012
IANYD. dephlogisticated is correct.
The lay term for mTBI is 'concussion', if you want to do further searching based on that, but really dephlogisticated's answer tells you all you need to know. A concussion is a bruise to the brain. It is diagnosed clinically, meaning by history and physical exam alone. Imaging of the head is not needed at the time of the injury or later, because nothing will show up on it.
posted by treehorn+bunny at 10:27 AM on December 7, 2012
The lay term for mTBI is 'concussion', if you want to do further searching based on that, but really dephlogisticated's answer tells you all you need to know. A concussion is a bruise to the brain. It is diagnosed clinically, meaning by history and physical exam alone. Imaging of the head is not needed at the time of the injury or later, because nothing will show up on it.
posted by treehorn+bunny at 10:27 AM on December 7, 2012
I was hit by a car as a teenager and bashed my head on the windshield, which shattered. Amazingly, it didn't hurt, but I went to the hospital and they insisted on keeping me there for hours in case I had delayed effects of the concussion. Because I was full of bravado, I didn't stick around for the MRI or X-ray or whatever they wanted to do (this was the NHS 30 years ago and it was a Friday night).
I didn't have a headache from the accident that day, the next day, or since, but I developed migraines four years later and wondered about a connection.
I didn't get an MRI until two years ago, when I'd chased away the migraines with preventive medicine but was having spasms in my right arm and the specialist wanted to check for Parkinson's or other brain injury. I told him about my teenage accident and he said it was unlikely that after-effects of the concussion were showing up now.
The MRI showed nothing untoward (and I was diagnosed with a fancy version of tennis elbow), but it put my mind at rest to see photographic slices of my brain with no bits missing. And it's really cool to see the pictures, too!
If you're concerned about your concussion, do talk to your doctor and see whether he/she thinks you should see a neurologist. It was partly covered by my crappy insurance, so hopefully yours will be better (I think I was about $800 out of pocket).
posted by vickyverky at 10:38 AM on December 7, 2012
I didn't have a headache from the accident that day, the next day, or since, but I developed migraines four years later and wondered about a connection.
I didn't get an MRI until two years ago, when I'd chased away the migraines with preventive medicine but was having spasms in my right arm and the specialist wanted to check for Parkinson's or other brain injury. I told him about my teenage accident and he said it was unlikely that after-effects of the concussion were showing up now.
The MRI showed nothing untoward (and I was diagnosed with a fancy version of tennis elbow), but it put my mind at rest to see photographic slices of my brain with no bits missing. And it's really cool to see the pictures, too!
If you're concerned about your concussion, do talk to your doctor and see whether he/she thinks you should see a neurologist. It was partly covered by my crappy insurance, so hopefully yours will be better (I think I was about $800 out of pocket).
posted by vickyverky at 10:38 AM on December 7, 2012
Coping with Mild Traumatic Brain Injury, by Stoler, helped me figure out what was due to my childhood mTBI and head injuries. A lot of my eccentricities suddenly had names, and it was no longer certain that they were the "real" me. About a decade ago the doctors (who figured my migraines were unrelated) found a drug that helped get rid of my migraines (NMDA receptor antagonist at a low dose, and getting a good night of sleep more often than not), and I've been watching things progress since. I'm *almost* back to the personality I had prior to the accidents, which is just amazing to think about. I haven't had it since first grade! Just keep in mind that not everything is due to the accident. Sometimes a cigar is just a cigar...
The "fun" side-effects like synthesia (happened twice - so cool) and deja vu * 6 (always with a disaster about to happen feeling) are all associated with where I sustained the most damage, so watching them change as my brain changes has been interesting. I could almost trace the healing parts of my brain as the side-effects changed. Most are completely gone now. I did find out my brain organizes words by parts of the sentence (nouns, verbs, adjectives, etc.) and phonetically, but I can also pull words by word structure (compare mitten and muffin - they are next to each other in my brain someplace). I'm also apparently infatuated with food. My brain has a lot of area devoted to it apparently. Shame it isn't math!
I'm also debating trying to "learn" how to hear better when background noises are present. Something as simple as a fan makes it hard to talk to people when in the same room, and I think it is due to the mTBI. Forget about conversations in crowded restaurants. Understanding opera, even in English, is impossible currently.
Tests have never shown anything, mainly because the damage we're talking about usually isn't large enough to be seen by modern tests. It's possible Magnetic Resonance Spectroscopy could be different, but a decade ago it maxed out at one inch cubes. For some strange reason I avoided it. :-) It might be better now. Doctors are usually behind, badly, on the modern research on central sensitization, neuronal plasticity, and such (my improvement isn't possible by most people's understanding), but things are changing VERY quickly. A lot is happening now due to IEDs in the Middle East, and the furor over head injuries in American football. A few years ago I would have said that this is really not an easy path to take if you want answers, but Stoler's book might help you understand yourself a bit. It's worth asking docs though. If you get frustrated, read The Cambridge Illustrated History of Medicine and you'll discover that neurology is extremely young. Aspirin just got popular after WW2. Good luck!
posted by jwells at 12:16 PM on December 7, 2012 [2 favorites]
The "fun" side-effects like synthesia (happened twice - so cool) and deja vu * 6 (always with a disaster about to happen feeling) are all associated with where I sustained the most damage, so watching them change as my brain changes has been interesting. I could almost trace the healing parts of my brain as the side-effects changed. Most are completely gone now. I did find out my brain organizes words by parts of the sentence (nouns, verbs, adjectives, etc.) and phonetically, but I can also pull words by word structure (compare mitten and muffin - they are next to each other in my brain someplace). I'm also apparently infatuated with food. My brain has a lot of area devoted to it apparently. Shame it isn't math!
I'm also debating trying to "learn" how to hear better when background noises are present. Something as simple as a fan makes it hard to talk to people when in the same room, and I think it is due to the mTBI. Forget about conversations in crowded restaurants. Understanding opera, even in English, is impossible currently.
Tests have never shown anything, mainly because the damage we're talking about usually isn't large enough to be seen by modern tests. It's possible Magnetic Resonance Spectroscopy could be different, but a decade ago it maxed out at one inch cubes. For some strange reason I avoided it. :-) It might be better now. Doctors are usually behind, badly, on the modern research on central sensitization, neuronal plasticity, and such (my improvement isn't possible by most people's understanding), but things are changing VERY quickly. A lot is happening now due to IEDs in the Middle East, and the furor over head injuries in American football. A few years ago I would have said that this is really not an easy path to take if you want answers, but Stoler's book might help you understand yourself a bit. It's worth asking docs though. If you get frustrated, read The Cambridge Illustrated History of Medicine and you'll discover that neurology is extremely young. Aspirin just got popular after WW2. Good luck!
posted by jwells at 12:16 PM on December 7, 2012 [2 favorites]
I had probably a dozen concussions as a kid, some of my friends had more or more severe ones. We all seem fairly normal to be honest I think its a very unlucky, very small percentage of people who have long term effects from those kinds of knocks and bangs.
I do have problems remembering names of people and things to a troubling degree but so does my mom so I think that's a separate issue. And it was never a problem academically.
posted by fshgrl at 2:23 PM on December 7, 2012
I do have problems remembering names of people and things to a troubling degree but so does my mom so I think that's a separate issue. And it was never a problem academically.
posted by fshgrl at 2:23 PM on December 7, 2012
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What kind of treatment would you want if something was found to be wrong with you from your injury?
-Would you be willing to undergo brain surgery and brave all of its risks?
-Take a medication everyday for the rest of your life and deal with its side effects?
-Be labelled disabled, file suit, and collect benefits?
Some times you have to do what you can, where you are, with what you have left.
To specifically answer your question. Imaging techniques could be used to rule out gross anatomical features like lesions from the injury, but wouldn't say much about the function of your brain.
Neuropsych testing could be used to assess the function of your brain, but since you probably don't have a baseline of neuropsych test results from before the injury, all that could be determined from them would be how you compared to the general population.
posted by 517 at 4:58 AM on December 7, 2012 [1 favorite]