I was in a serious car accident and sustained a major blow to my head. The CT scan came out negative, but I had a lump literally the size of an egg on my forehead, two black eyes and bruises to the rest of my body and head. I have been evaluated by a neuropsychologist who states that there is nothing wrong with me that was not present before the accident, and that I am complaining of problems for which there is no physical evidence. The neuropsychologist has many academic degrees, so I am questioning myself! It is so hard to put my finger on what is wrong, but it takes me ten times longer to do things now than before the injury. My house used to be immaculate and now it's a disaster. Is it possible that this professional, who is apparently highly trained (and has written books and given lectures), is wrong?
It is not uncommon for someone who sustains a mild brain injury to receive a clean CT scan. You were smart to consult a neuropsychologist for more diagnostic information. And, the neuropsychologist's conclusion that your problems were present before your injury makes sense. If you stunk in math before your injury, you'll still be counting on your fingers after the accident. A person with depression prior to the accident probably will emerge from the injury with depression. In fact, the depression may be worse because you are reacting to the fact that you experienced a traumatic event. There may be no physical/organic cause for your depression that did not exist prior to the accident. You simply would be reacting normally to a traumatic event. What you need to do is find out why you take longer to get things done, to clean house, etc. if these problems did not exist before the accident. Feeling slowed down is very common after a brain injury, by the way. You may benefit by getting a second opinion from another neuropsychologist or a neuropsychiatrist if you feel that you need medication. This does not diminish the opinion of the first neuropsychologist; a second opinion simply gives you more information.
My 16-year-old son had a moderate brain injury about 18 months ago as the result of a car accident. He still struggles for word identification. Some words he appears unable to retrieve, no matter how hard he tries. These are words which he did not frequently use before the accident. Is this a learning impairment that he might overcome with repetition, or are there some words that may never become part of his vocabulary?
Even though your son was injured over one year ago, he still can continue to make progress. It is worth the effort to assess his current problems and pursue treatments that may help. You can take the first step in this assessment and then consult the appropriate professional(s).
First step: Make a written record of the communication problems. Try to answer the following questions.
What words are problematic? Your current observations are very helpful -- he has trouble with words not used pre-injury. Your son is having difficulty partly because information learned prior to an injury may be easier to recall than information attempted post-injury.
Are there any clues to why he cannot say certain words? Is he receiving your message? That is, can he hear and understand what you are saying to him? If so, does he have the ability to express himself? For example, can he mentally retrieve words? physically speak the words? put them in a meaningful sentence?
Note the environments in which problems occur. Are there distractions in the environment? Is it too noisy? I someone making him nervous?
As you can see, communication involves complex cognitive and physical functions. Once you have gathered detailed information about your son's difficulties, you may wish to consult a speech language pathologist for an evaluation of your son and therapy recommendations. The speech language pathologist can advise your family with suggestions such as speaking only when facing your son, slowing down your rate of speech, simplifying your vocabulary, etc. If a hearing problem is suspected, an audiologist may be consulted.
(Reference: Blosser, J., DePompei, R. (1996). Crossing the Communication Bridge: Speech, Language and Brain Injury. Brain Injury Association, Inc.: Alexandria, Virginia.)
About 10 years ago, I fell out of a truck that was towing a camper. I was run over by the back wheel of the truck and had numerous cuts and bruises. I was very lucky to be alive! The most serious issue after my accident was a "personality change." Everyone noticed it! My sister said it was like I was a stranger! My taste in food, music, and clothes changed. I even lost a fear of heights I always had! Is this type of change common?
Actually, personality and behavior changes are quite common after a brain injury. Many people experience a decrease in inhibition – making them less anxious about things. On the other hand, it can also make them more impulsive, aggressive or irritable. Some people even describe the person as being calmer and quieter after an injury. It’s hard to predict and sometimes the changes are temporary. Also, sometimes people who experience a traumatic event that brings them close to death make changes in their lives that have nothing to do with a brain injury.
I had a TBI in October 1996. The thing I notice now is that I obsess over certain things. For example, I’ll take a bottle of Windex and some paper towels in my room and start cleaning EVERYTHING. What’s up with that? I mean it’s bad enough to have obsessions, but getting into a cleaning frenzy?
Maybe you can clean Pat’s office? On the other hand, even you might not be able to handle that!
You may be experiencing symptoms of obsessive-compulsive disorder. It depends on how often you obsess and how much it disrupts your life. Obsessive-compulsive disorder has been linked to several areas of the brain including the frontal lobe and the neurotransmitter called serotonin. It is possible that damage to certain parts of your brain such as the frontal lobe may have contributed to your symptoms. Medications affecting serotonin such as Prozac and Luvox have been used with some success in treating OCD. In addition, cognitive-behavior therapy can be very effective, particularly for milder cases. Don’t be afraid to seek help. Talk to your physician or make an appointment with a psychiatrist or psychologist who can help you evaluate your symptoms and discuss options.
My dad is a young 65 and had a subarachnoid hemorrhage in November 98. He’s spent the last 6 months in this great transitional living center for brain injured people. He’s almost ready to go "home" and herein lies the problem. Before his brain hemorrhage he was extremely independent. He managed investment property for his family. He put over 70,000 miles on his car last year. He divorced my mom and has had no permanent home for the last couple of years. Right now he has a very structured environment. He’s great in the moment and doesn’t confabulate any more. However, he’s been obsessing over opening his own rehab center (brings up the subject every 10 minutes as if we’ve never discussed it). We have to remind him that he can’t run a business if he can’t remember what happened the day before. The senior day programs are not stimulating enough for my dad. He has to do something with more purpose than playing cards. My aunt said she’d love to live with my dad, but doesn’t know what he’ll do every day. My sister and I also live in San Francisco. Are there any programs in the San Francisco area for brain injured people like my dad? That is, for an active, capable person who needs a little extra guidance, compassion, and consideration of his deficits? Thanks so much for your help.
It sounds like your dad is a pretty interesting guy who can still do a lot of things and has some big dreams. Usually what I recommend is for the family and the patient to visit several facilities to see which one is the best match for the patient. You and your father will better be able to judge if a facility is a good match for him than any "expert." If your dad does need 24-hour supervision or cannot be left alone, it may be necessary for you to use an adult care facility even if it’s not the "best" possible option. A less restrictive option may be to locate mentors or other people that can work with brain injury survivors one-to-one. Find out if there are local brain injury support groups. Often these are the best sources for ideas and information since they consist of survivors and family members who have gone through similar situations.
On the other hand, if your father only needs minimal supervision your family may be able to help out a lot. Most people very much prefer the company of their family to the company of strangers. If you, your sister, and your aunt all work during the day, perhaps you could hire someone to provide in-home or part-time supervision. Maybe as your dad recovers, he will require less supervision during the day and can live with a family member without the need for daytime supervision.
Consider consultation with a physiatrist or neuropsychologist who may be able to assess your father’s strengths and weaknesses, suggest an appropriate level of care, and refer you to the necessary resources.
I have written to you before and was very encouraged by what you wrote back. I had a CHI on July 30, 1998, and I'm still trying to figure things out. It's so hard for me to be around people that I don't know for fear that I may seem "strange" to them, etc. Even to be around people that I know, but have not seen me or spoken to me since the accident. I feel so on edge, afraid that they are looking for deficits, or just maybe trying to see what's different. So many people are not at all educated about brain injuries and think that anyone with a brain injury is instantly impaired, or has mental problems. That is true in some cases, but definitely not all. I've been through a lot since all of this happened, and I feel like I've come out of it wiser. I've noticed that the more hardships people have to go through, the more levelheaded they seem to be. Somehow, I have to get over this fear of being around new people. Half the time I feel like I need to explain what happened, when I truly know that it's not necessary. It's so hard to put these tense moments into words. How should I get over this?
I don’t think I’ve met a person with brain injury who didn’t feel this way to some extent. Figuring out what to tell people about an injury or even whether to tell people anything at all can be difficult. Loss of confidence and worrying about making a mistake are also common experiences of people after a brain injury. Many people who were previously comfortable around people become "shy" after the injury. They’re worried about what others think and about making a mistake that will let others know they are "weird."
Pat is glad to hear you already know that explanations aren’t necessary! Your injury is YOUR business. You do get to decide who to tell and who not to tell. Besides, a lot of the time the person who is most likely to notice "deficits" is the person with the brain injury! After all, everyone sometimes forgets things, seems distracted, is emotional, or can’t think of the right word. Obviously if your injury is more noticeable from your appearance, speech, or behavior, this can be more difficult to handle since people will wonder and many will ask. But one of the things about TBI is that the person often looks "healthy." (Although this can have drawbacks too since others may not be as sympathetic or understanding).
As for how to get over the anxiety, there are a few things to try. One is to practice these situations with a friend, family member or therapist. Are there particular types of situations that make you nervous? Are there questions you’re not sure how to answer? Is the flow of the conversation disrupted because of confusion or a memory problem? If you can rehearse these situations, you can build up confidence for life in the real situation. A therapist may be able to help you analyze what aspects of social situations make you uncomfortable and provide relaxation techniques to deal with anxiety. Finally, participation in a support group for brain injury may be helpful. I can guarantee if you go to a group, you will find others dealing with similar issues. Advice and feedback from someone who has been there is often the best thing.
I am new to the site, looking for information. When I was nine (I Am 37) I suffered a massive head trauma to the back of my skull on the left (near center) part of my head... I was struck by a falling bolder in a Hiking accident... It broke the skull and the bone was pressing down on the skull... It took quite a while to get down off the mountain and I spent 3 days in a coma and the surgeon told my parents I was going to die. He reconstructed the bone and stitched me up and you know I woke up! Now I have never had follow up tests, but I am a real slow reader and I can not type with out looking at the keyboard (and then I am REAL Slow) Often getting letters out of order in words... I have never been able to match Music Notes to finger positions, even though I can play a few instruments by ear, and can read Music... or at least used to try... I have had difficulty with dyslexia my whole life... I cannot remember most people’s names or phone numbers (even the ones I call a lot.) I am an artist and very "right-brained" I wonder if there are programs in my area that might evaluate my damage and perhaps take me on as a patient. I am also interested in possibly participating in Human research projects that might help re-stimulate my damaged memory centers, or even might be interested in using my existing damage to get around the FED limitations to working on "Healthy" tissue. I know this might seem like a lot to ask about, but my request is sincere and I am not having much luck connecting to anywhere.
Are there programs in your area that might evaluate your "damage" or take you on as a patient? In terms of an evaluation, you could certainly arrange to have neuro-imaging done to look for any structural anomalies in the brain. You could also have a neuropsychological evaluation to look at your cognitive strengths and weaknesses. Any rehabilitation program working with people with brain injury should be able to perform these services or refer you to someone who does. Ask your primary care physician for help in finding the resources in your area. As for taking you on as a patient – that would depend entirely on what you might need help with.
I’m afraid I can’t give you much guidance as far as participating in research. That would depend on what kinds of research projects might be run at hospitals or universities near you. The fact that your injury occurred so long ago and occurred while you were a child may also limit how many research studies you could be included in.
I was in a coma for a month and a half from an auto accident. It happened this February. It is hard for me to explain what I am going through. I was working on a Masters degree at Texas Tech after graduating from Louisiana Tech. I am a 36-year-old male I just went to college because after 13 years I finally got out of the Navy. My long-term memory is real good but my short-term memory is bad. I feel like my wife has to put up with another child. I have a quicker temper than I did before the accident and I have a real problem tolerating my kids. I am presently out of rehab and I don't know what to do. Any ideas you have would be greatly appreciated Thank you.
First, I should tell you that what you are experiencing is very common. Short-term memory problems, irritability, and a lower tolerance for stress are among the most frequent symptoms among survivors of brain injury. In addition, people often feel misunderstood by family members – especially if they look healthy on the outside. It is important that you talk to your family. For example, when you say, "I feel like my wife has to put up with another child." – is this how she feels, or is it how you think she feels? Have the two of you discussed the injury’s impact on your relationship?
A therapist with experience working with persons with brain injury can help you to develop ways to manage your anger and frustration. Consider involving your wife in therapy so you can address these problems together. In some cases, there may be medications that can help you better control emotions. You might want to start by keeping what behavior therapists call an ABC diary of the times you get angry. At the end of each day, write down all the things that made you angry using this system:
Antecedent – this is what was happening before you got angry. For example, if you were angry with the kids, what were you doing before you were angry? What led up to the anger? What were you thinking? What were you feeling? (For example, were you thinking about a problem? Were you already upset about something?).
Behavior – this is what you actually did when you were angry. For example, if you were angry because your child misbehaved, what did you do? Did you yell? Curse? Throw things? Hit a wall? What were you thinking about when you were angry?
Consequence – how did things end? How did you calm down again? How long did it take to calm down? Did you accomplish what you wanted to accomplish? (For example, did your children learn what they did wrong and receive appropriate discipline? Did you solve a problem with your wife?) Did you feel better? What was the effect on the people around you? Were they upset? Crying? Avoiding you? It is important to look at the consequences of your anger in order to identify ways to more effectively achieve a desirable outcome.
By keeping a diary like this, you can identify situations that tend to create anger and frustration in your life. There may be ways to avoid some situations that lead to anger and frustration. Are there situations that made you angry that shouldn’t have? Are there situations where your anger is appropriate? You may also identify times of the day, things you’re thinking about, your mood, or something else that contributes to your anger. You might be surprised about what you learn.
You also should keep in mind that everyone gets angry – and sometimes for good reason! How you deal with your anger is very important. Feeling angry is one thing. How you behave is another. It is the behavior that is most important to control. This is especially true with your children. All parents get angry, but good parents maintain enough self control that they don’t curse at, belittle, scream at, or hit their children. Instead they express their anger in a way that both lets the child know what the parent is angry about, teaches a lesson, and reminds the child they are loved even when they do something wrong.
Consider what type of outcome you want when something makes you angry. How can you best accomplish that outcome? Try to figure out ways to express your anger in a way that gets your point across without hurting others. If your anger is especially hard to control, talk to your family about how you would like them to respond when you are angry. For example, should they leave you alone or give you reassurance? What works best for you and your family? Most of the time, when people look at the "C" part of their diary, they find their anger isn’t making things better and they need to find ways to change. Talking with your wife and a therapist about ways to cope will help immensely.
My father was recently in an automobile accident where he suffered brain trauma, I have many concerns. He is very lucky to have lived because his BAL was three times the legal limit. From this accident, he suffered three skull fractures and two hematomas, one on each side of the brain. He was never in a comatose state. It is 2 1/2 weeks later and he talking to people and is even remembering things from the past. He now has a very short attention span and occasionally has childish spells. I am wondering what type of behavior is typical for people who have suffered basilar and occipital fractures, and what role his hematomas may play a part in his recovery. I must also add that there have been a series of CT and the hematomas have gone down, the doctors expect them to take care of themselves, although later it may be necessary to drain them. Do you have any advice? Thank you!
Hematomas are blood clotting in tissue. I’m sure your father’s physicians will monitor these closely. As you noted, surgery is sometimes required to remove the clots. As for "typical behavior," it is very difficulty to predict brain injury outcome from skull fractures, or points of impact. The reason is that in high-speed traumas such as motor vehicle accidents, the brain can sustain multiple impacts as the person (and the brain) bounces around during accident. The brain often rebounds inside the skull creating injuries opposite the point of impact. In addition, diffuse injuries can occur because of rotational forces. Alcohol use at the time of injury further complicates the picture. Research has shown the persons who are intoxicated at the time of a brain injury are likely to have more problematic post-injury symptoms. Hopefully your father will beat the odds in this regard. To sum up, behavior is just very difficult to predict based on a CT or a MRI. As frustrating as it may be, there usually isn’t much to do, but "wait and see."
Probably the best advice is to be patient and remember that recovery from brain injury is a long-term process. You will have a better sense for how your father’s recovery is going after about six to twelve months. It is important that he follow all his doctors' treatment recommendations and that he refrain from alcohol use (which limits recovery). You may also want to consider having a neuropsychological examination done to establish a baseline against which you can measure future recovery.