Ronald E. Snyder, M.D.     Rolando Amadeo, M.D.
Board Certified Specialists

By the very nature of its name, a brain injury can be terribly traumatic. Anything from slight whiplash to a blow to the head can cause a range of symptoms to occur, any one of which can lead to brutal living consequences.

The brain is incredibly complex – and as a result, any injury on its delicate structure can cause a range of effects. Here at My MDDs, our goal is to find out what our patient's brain is struggling with, and offer specialized care and rehabilitation to ensure a satisfying life.

Frequency of Brain Injury

Brain injuries are unfortunately common: as many as 1.4 million people sustain a brain injury each year according to the Center for Disease Control. The injury itself isn't what presents medicine with such difficulties in diagnosis and treatment – it's the fact that, as a result of injury, the brain unfurls a list of symptoms that amounts to a multi-faceted, complex disease often underfunded and under researched in the field of medicine.

The misconception around brain injuries is unreal: many persons with mild to moderate injury are often treated or seen by many physicians and psychologist who had dismissed them as the professional did not appreciate the significant functional loss from an injury, as per the CDC's fact about concussion and brain injury.

However, due to the complex nature of brain injuries, it's not uncommon to suffer one – and not even know about it at first.

How Do You Know You Had A Concussion

Jell-O

Fifty to 86 percent of all brain injuries are classified as mild. The majority of traumatic brain injuries is the result of motor vehicle, bicycle, or pedestrian related accidents, followed by falls, violence, and sports injuries, according to the NIH. These mild injuries can still lead to major issues; as per an excerpt from the Neuro Medical Diagnosis and Management Post Concussion Disorders:

"The literature suggests a significant, albeit small, subset of patients with mild traumatic brain injury did not make a full functional recovery. Patient's with long-term impairments may show some resolution of symptoms over time; whereas, others may have permanent impairments and permanent disabilities."

However, what truly counts is the diagnosis of a brain injury. Here at My MDDs, we deal with proper, strenuous and detailed testing.

Testing for Mild Traumatic Brain Injury

There are a few certified ways to test a patient for brain injury. Here are a few services we offer in the field:

MRI and CT Scans: In minor brain injury patient's, MRI has been available to document evidence of diffuse axonal injury in patients who have normal CT scans. However, most MRIs and CT scans revealed no abnormality at times with mild traumatic brain injury.

MRI and CT scans

Neuropsychology Testing: While traumatic brain injury is an organic injury to the brain, people with this injury often experience psychological and neuropsychiatric consequences to that injury. These people often experience emotional instability, depression, and anxiety that often require therapeutic intervention and a neuro-psychiatrist to prescribe and administer medicine.

Neuropsychological testing which can be defined as the administration of specialized psychological tests to patients with suspected focal brain injury. These tests then identify altered cognitive, behavioral, and emotional functions and factors that may influence the patient's functioning. Think of a hearing test, done to ensure that the tympanic membrane is intact after an accident.

As an example of such a test, a neuro-psychiatrist may ask a patient to remember simple sequences, like "A-B-C-D-E" or "1-2-3-4," which are really not new learning or recent memory, but rather old rote memory, another area of the brain.

Another example tests the visual-spatial and visual organization capabilities of a patient, by asking them to copy a geometric figure, or draw a clock or a compass.

Colorized DTI and Weighted SPECT Scans: Recent neuroimaging studies have been utilized in identifying loss of axons; however, in even severely disabled individual patients often have negative imaging studies, making these not optimal for all patients.

Even after proper imaging and diagnosis is complete, all brain injuries possess some form of consequence – at times permanent.

Weighted SPECT Scans Colorized DTI

Loss of Function Following Traumatic Brain Injury

Functional changes following brain injury are different than a broken bone which heals over time. Studies show that even a busted knee can, with rehabilitation, return to full strength after anywhere between a few months and two years.

Yet while broken bones eventually heal, cognitive, sensorimotor, and behavioral deficits can result in lifelong changes in how an individual functions and socializes. Any one of the functional changes can significantly impact every aspect of the person's life:

  • Cognitive Impairments can effect activities of daily living such as hygiene, eating, household management, community reintegration, and many other aspects of day-to-day living. Memory is one aspect.
  • Executive Functioning often becomes a problem with frontal lobe injuries. Ability to keep a business running requires organization, planning, creating, evaluating, and initiating projects and activities.
  • Initiation Problems may result in a person failing to engage in important activity unless prompted. This makes a majority of life difficult, from exercise to hygiene and even interpersonal relationships.
  • Changes in Thinking include lack of awareness of deficits (anosognosia), confusion such as disorientation to person place or time, distraction, reduced ability to pay attention, difficulty changing routines, difficulty with basic calculation, difficulty sequencing, lack of empathy, and other issues with reasoning.
  • Behavioral Changes and emotional changes are common following brain injury. These symptoms include the inability to respond to requests, and a myriad of aggressive tendencies.
  • Physical Difficulties occurs when injury occurs to the motor strip (posterior frontal), motor planning (prefrontal cortex) as well as coordination (cerebellum) with resultant poor motor control – the inability to properly coordinate your limbs and body.

Because of the nature of the brain, nearly no two brain injuries are exactly the same. However, treatment for a myriad of brain injuries in all forms of severity are available.

Treatment for Traumatic Brain Injury

Medical treatment first requires identifying:

  • The fact an injury occurred,
  • Where the injury occurred,
  • Identifying all of the physical, emotional, and cognitive ramifications.

Many times the patient will lose their jobs, spouses, as well as other spheres of personal social influences due to the patient's newly compromised abilities; leaving them only with professional providers for long-term care.

For these people, specific vocational rehabilitation will be necessary to try and bring them back to function. Some brain injuries result in heavy damages, requiring proper life-long planning.

Life Care Planning

One of our offers as medical practitioners is to aid in the creation of a Life Care Planning document. A Life Care Plan is an active document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized and concise plan for current and future needs, with associated costs for individuals who have experienced catastrophic injury or have chronic health needs.

Life Care Planning Goals are created and discerned to improve or maintain the clinical state of the patient, prevent secondary complication, provide the projected clinical and physical environment for optimal recovery, and enlist support to the family, as well as prevent unnecessary complications. The treatments and care will never return the patient back to pre-injury levels of function or anatomical wholeness, but it will address several demands.

Physical Demands: Neurological and Orthopedic consequences produce (to varying degrees) reduced levels of function in sitting, standing, walking, reaching, holding, pushing, and pulling.

Cognitive Demands: In most instances, the changes from a less physically demanding workplace move to progressively increase cognitive responsibilities.

Associated Responses to Anatomical and Cognitive Impairment: Associated responses to anatomical and cognitive impairments result in psychological disturbance, and social upheaval.

Life Care Planning is a process where long term professional, therapeutic, and supportive care is evaluated as well as equipment and pharmacological needs are assessed, as well as bracing, transportation issues and required potential vocational support.

There's no doubting the fact that a brain injury is extremely hard to come back from – but with the right support, knowledge, and the help of an experienced team of medical professionals, you can get your life back on track.

 

 

MD Diagnostic Specialists

Maitland Office: 668 North Orlando Avenue, Suite 1010 • Maitland,FL32751
Phone: (407) 644-0101 FAX: (321) 441-1559
 
Contact Us: Info@myMDDS.com
New Patients: NewPatient@myMDDS.com

Feel free to contact us with any questions or concerns you may have. We will gladly contact you within 24 hours.