Mild Traumatic Brain Injury
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MILD TRAUMATIC BRAIN INJURY
MECHANISMS OF INJURY
An injury severe enough to produce a mTBI can result in a diffuse injury and /or
focal brain damage (see illustration). Diffuse injuries can produce widespread damage
following acceleration and then rapid deceleration of the brain resulting in
damage to the axons that course through the brain. Focal damage can occur in
the frontal lobe and/or temporal regions. It should be noted that
damage to the brain may not be seen on CT scans. Neuroimaging via MRI may
identify the damage. The pathophysiology of mild TBI is beyond the scope of this
section. Interested readers are referred to Gennerelli (1986)or Hayes,
Povlishock & Singha (1992).
Common symptoms: Mild TBI can result in both cognitive and physical
symptoms. Not all of these symptoms may be apparent at the time of the injury.
Children may experience a constellation of both "early" and "late" appearing
symptoms. Immediately or during the first few days following the mTBI
(ie "early") the child may experience:
- headaches
- nausea & vomiting
- blurred vision
- tinnitus (ringing in ear)
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- dizziness
- stiff neck
- fatigue
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These problems can have an adverse impact on academic performance and interpersonal relations. If the child doesn't have any physical signs of injury (e.g. a broken are) and/or some time has transpired since the injury, some individuals may mistake these symptoms as representing attention seeking behavior, poor motivation, a "negative attitude" or simply the manifestations of a previously known problem (e.g. the child with a history of dyslexia sustains a mild TBI and now finds reading even more difficult is viewed as "not trying").
"Late" appearing symptoms are those symptoms that may occur days later after
the child returns to the more cognitively demanding school and psychosocial
environment. Some examples of these problems include:
- slow information processing
- reduced new learning
- disorganization
- reduced frustration level
- rapid mood changes, irritability
- problems in processing mulitiple bits of information simultaneously
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- too much or too little sleep
- reduced mental stamina
- difficulties in retrieving previously learned information
- perplexity and confusion
- starting spells
- reports of being "overloaded" or "overwhelmed"
- increased sensitivity to noise
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These problems can have an adverse impact on academic performance and
interpersonal relationships. If the child doesn't have any physical signs of the
injury and/or some time has transpired since the injury, some individuals may
mistake these.