My Life in Brain Injuries

Myth #5: It’s called mild traumatic brain injury because it isn’t serious.

The nomenclature is unfortunate. “Mild” simply means the skull was not fractured and if the person lost consciousness, it was for no more than a few minutes. The consequences of a mild TBI may include:

• confusion
• headache
• lightheadedness/dizziness
• blurred vision or tired eyes
• ringing in the ears
• bad taste in the mouth
• fatigue or lethargy
• a change in sleep patterns
• behavioral or mood changes,
• trouble with memory, concentration, attention, or thinking.

Myth #6: If a person’s pupils aren’t different sizes, they don’t have a brain injury.

Unequal pupil size is called anisocoria. Physiological anisocoria is when there is a natural difference in the size of a person’s pupils, a harmless situation not indicating a brain injury.  However, a pronounced change in one pupil size later in life can indicate a serious medical condition – not necessarily a brain injury – that does require immediate consultation with a physician.

And, the pupils may not change size at all, depending on where in the brain the injury occurs.

Myth #7: Mild TBIs do not cause permanent damage.

Many people have more symptoms at one year out than immediately following an injury.

Researchers at the University of Pennsylvania suggest that Alzheimer’s disease-like neurodegeneration may be initiated or accelerated following a single traumatic brain injury, even in young adults. Both tau tangles and amyloid-beta plaques have been found in survivors, years after a single moderate-to-severe TBI.

Repeated mild TBIs may aggregate, contributing to a later diagnosis of chronic traumatic encephalopathy (CTE).

Myth #8: MRIs, CT scans will identify TBI.

Most damage to the brain is on the microscopic level and rarely shows up at the larger scale of CTs or MRIs.

Myth #9: IQ tests rule out long term effects of TBI.

IQ tests assess a grasp of material already learned, but can’t predict how someone will process information in the future.

Myth #10: Kids don’t get TBIs.

Wouldn’t that be great? Children do not lose consciousness as easily as adults, so it is easy to assume they haven’t been hurt. TBI, however, is a leading cause of death and disability among children and adolescents in the U.S., especially when firearms are involved. Each year, an estimated 50,000–60,000 U.S. children are hospitalized for TBI, at a rate of 70–75 cases per 100,000 children. And those are just the ones that people notice. 

Myth #11: The younger the patient, the faster and more complete the recovery from TBI

It is true that children’s brains are highly plastic, and healing is more likely, but measurements used to evaluate brain injury were developed for adults. Because a child’s brain is still developing at the time of injury, the effects may be permanent. It is likely subsequent problems the child may face will not be attributed to the TBI since we have no way of measuring who that child could have been without the injury. Children and teens are often treated for psychiatric disorders without consideration of possible brain injuries. Teenagers are much more likely to be considered “hormonal” than injured.

Myth #12: There has been an increase in pediatric TBI in the last 20 years.

Probably not. There HAS been an increase in awareness of TBI and an increase in adult supervision of children’s play. Therefore, when a kid falls from the monkey bars, an adult is more likely to notice and intervene. The idea that the previous generations of free-range children had fewer brain injuries is laughable.

Myth #13: A person with no physical symptoms has completely recovered from TBI.

There is no correlation between motor function and cognitive or behavioral recovery. People can and do look perfectly normal even though their brains are decompensating. This factor has a lot to do with compassion fatigue – without visual cues that a person is suffering, it is hard for family, friends, employees, and or co-workers to be supportive.

“People think I’m faking when I try to explain what’s wrong with me, but what they don’t understand is that I’m faking it when I seem well. It’s exhausting to fake it.” TBI survivor

Myth #14: Only retired professional athletes get CTE.

Chronic traumatic encephalopathy (CTE) is a degenerative brain disease found in people who have a history of repeated TBIs. With our current level of technology, it can be diagnosed only during an autopsy. Most of the news about CTE has been related to NFL players, with a recent postmortem review finding it present in 110 of 111 brains of deceased NFL players, but it occurs in other populations such as military members/veterans and athletes who participate in other contact sports. Once thought to be present only in people at the end of long careers, it has recently been found in the brains of high school and college athletes. There is a strong correlation between CTE and suicide.