Head injury
I’ve given presentations on head injury. Presentations have been given by others on head injury. There’s some basic information out there. Psychology and neuropsychology devoted an entire decade to research on the brain. My husband asked me why it takes scientists so long to accept information. It’s part of the nature of science. It takes a long time to change thinking.
Most people recover from mild head injury just fine. You bang your head you get over it. The more often you bang your head, the less well you get over it. The harder you bang it and the more damage you do to your brain, the less well you get over it. Head injuries aren’t additive, they are multiplicative. It’s not head injury 1 plus head inury 2. It’s head injury 1 times head injury 2. Further the effects of head injury, like the onset of seizures, can be delayed as long as 18 months post injury. So, you fall and bang your head and think it’s nothing but a pain. You get up and are nauseous, maybe you even vomit. Nothing happens. 12 to 18 months later all of a sudden you fall on the floor and flop around like a fish. You end up in an emergency room. An MD asks you if you have hit your head and you don’t remember that fall a year ago almost 2 years ago and it seems completely unrelated. So the MD decides there’s no cause for the seizure. But there was. You have a 400% greater risk for more seizures and should be on medication or should be followed closely, but no one has a clue. No one can tell you there are activities you should avoid and should have been avoiding for the past year. Instead you get told it was a one time event, it’s no big deal and not to worry.
Head injuries are so common and so mild most of the time they are ignored. You get hit in the head with a softball from your kid. You stand up suddenly and bang your head on the bottom of a cabinet. You slip and fall and hit the back of your head. You suddenly change position and get sick to your stomach. You go on a ride at an amusement park or at a carnaval and it bounces you or spins you around and you get sick or get a headache. You are in a car accident at 20 to 50 mph and snap your neck when the car is rear ended. The dog head butts you in the face or jaw. You’ve got some pain, but you think you are fine. Eight times out of 10 you probably are. It’s those other two times that are the mess. You might know when you throw up or get dizzy. You might know when the strange migraine-like headaches start that let you know you’ve had a minor concussion. You might just never know and think you got sick and got the flu.
Post-concussive headaches follow mild head injuries often. They get labelled as migraines. Real migraines cause your havds to get cold. They are caused by vascular changes. Post-concussive headaches are caused by your brain bouncing into your skull. Your hands don’t get cold. The rest of the migraine-like symptoms are the same. Sensitivity to light, sound, and movement, and feeling better with vomitting. The nerves in the brain have been sheared and need to reconnect. The pain frequency and intensity decreases over time. Over 2 to 5 years the pain diminishes almost completely. In some cases it continues at a low level.
The entire room can be spinning. Dizziness can come with head injury. It comes from damage to the inner ear. It causes vertigo–the sensation that the room spins. It causes loss of balance. It increases the likelihood of more falls.
The more often you bang your head the more problems there will be with thinking. Where you bang your head will determine what kinds of problems with thinking you will have. Remember these are only the 2 out of 10 cases. Most people are right handed. Most people have the right side of their brain involved in recognition, math calculation, drawing things, organizing and synthesis of some types of tasks. The left side of the brain is involved in speaking, paying attention, thinking and explaining things. This is overly simplified but gives an idea. Some left handed people have this organization, others have the sides reversed.
There are even more problems if there is bleeding and swelling. The brain is in an enclosed space. There isn’t much place for expansion in closed head injuries. As the damage expands, structures deeper into the brain are impacted. Problems with regulation of the body’s organs and the endocrine system show up in a small percentage of people following head injury. Some people develop heart problems or go on to develop diabetes, thyroid, or other endocrine disorders.
Now what I have been telling people is that with closed head injury with the 2 of 10 people who have symptoms that they are at risk for significant complications. They are already in an unusual population. If they have not had a seizure, they are at risk for seizures for 18 months post head injury. I advise people not to do any activities that can further injure their brains. No contact sports, no motorcycle riding, no horse back riding, no rollerskating, no roller coaster riding for 5 years post head injury. After that time period, the risk of significant “unexplained” brain bleed, sudden death, or sudden unexplained seizures decreases dramatically and the risk should be the same as anyone.
I saw a child with a history of an unexplained seizure last year. One grand mal seizure where she fell on the floor and flopped around like a fish. No history of any head injury. Except she had a bad stomachache right before she flopped. So I had an idea. My idea was that she had a head injury, probably several. So I started asking. The head injuries started a full 2 years before at a carnaval where she was on a bouncy ride and was bounced all over and got really dizzy and then wanted to go home. Before that there was the time she hit her head and cut it and got a bump. You can still see the scar. Then there were all the times she was hit in the head on the playground with bounce balls or hand balls. I lost count after we got to the fouth head injury before that “unexplained seizure.” Now it’s no longer 1 seizure, it’s more likely her 3rd, but the first that was grand mal. The rest were smaller, petit mal seizures and are ongoing. It’s why she was having those accidents at school and never quite made it to the bathroom in time. Now she can get treatment. Now everyone knows the history. It’s not “unexplained.”
