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Brain Injury Consultation

For Partners and Family
Of Individuals Living with a Brain Injury

In the medical field, I have journeyed over 10 years alongside patients who have suffered a wide variety and levels of brain injury whether cumulative sub-concussive trauma (insults to the brain that don't meet full concussion criteria), concussion/s, post concussion syndrome, minor traumatic brain injury, traumatic brain injury, or acquired brain injury. I have witnessed how this injury can turn every aspect of life upside down. Everything from career and finances, to hobbies, social life, family, parenting, marriage/partnership, sex life, and basic quality of life. And, while many of my patients had multiple medical providers, few had anyone to help them or their loved ones to process the injury (or how it happened) and the myriad, ongoing losses and stressors that accompany it.

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Brain injury has many faces, many of which aren't commonly known. It is profoundly isolating and acutely misunderstood by the public and even many medical professionals. For many, the words brain injury brings up an image of a survivor of a severe open head injury who may no longer be able  to communicate. While this form of brain injury does happen, it is the extreme and does not represent the wide range and complexity of what a brain injury can be.  Injury to the brain, like many things, occurs on a continuum. What I just described is on the extremity of one end. On the other, is the neighborhood kid who plays soccer and does headers but as of yet has no noted symptoms (or at least no acknowledged symptoms). It's important however to not misconstrue this as no harm having occurred.

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There is no such thing as a safe blow to the head.

~Dr. Bennet Omalu 

This is, in part, due to the fact that there is no seatbelt for the human brain, pointed-out eloquently by Dr. Bennet Omalu as seen in the movie Concussion.

 

Because of the continuum of injury, the vast majority of individuals living with ongoing symptoms are people all around, whom you likely don't realize live with post concussion syndrome or mild traumatic brain injury.

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Injury to the brain is cumulative. The brain keeps score and never completely heals after an injury. At some undefined point (unique to every individual), the line is crossed into symptoms that resolve with time. At a further undefined point, a second line is crossed into symptoms that persist. For those for whom symptoms linger, there is often a long medical journey that frequently includes medical professionals from multiple specialties.

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Because of a complex sequelae of medical events, symptoms can appear as long as 3 months after an incident. It can also be a cumulation of events over a period of years with a final insult that is the proverbial straw that broke the camel's back. This can make it hard to connect the symptoms with the cause and make it seem like they mysteriously came out of nowhere. 

 

Injury to the brain has a unique collection of symptoms that to the outsider can sound very strange, and the ways in which a person adapts or copes with these symptoms can appear even stranger. When you understand the medical reason behind the symptoms they make clear sense, but without that it can seem as if your loved one has become eccentric, capricious, agoraphobic, or gone a tad bit nutty. This can be a place of great tension in partnerships and marriages, and part of where I can help. 

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Likely the nuances of life with a brain injury are new to you and you have lots of questions. Consulting with me can help to make sense of what you and your loved one are going through, help you know how to help, point you in possible directions worth pursuing, and offer tools to ease the path ahead. If what I have written thus far has been helpful to you, I  invite you to peruse the lists of myths, symptoms and paths to injury below and consider scheduling a consultation. 

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Common Myths

There are a lot of misconceptions about brain injury. Here are a few that come to mind.

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  • If the MRI or CT scan was clean, no injury occurred

  • Concussions symptoms always resolve in hours or weeks. 

  • After 1-2 years, that is the most healing that is possible

  • Brain injury means an open head wound

  • Concussions require a loss of consciousness

  • You have to hit your head to hurt your brain

  • Sports such as soccer and football don't have a long-term impact on the brain

  • Return to Play rules ensure it's safe to return to play

  • Helmets prevent concussions

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Paths to Brain Injury

Research has extensively shown that the brain is much more sensitive than has previously been believed. We frequently underestimate the g forces of a particular incident, such as the impact of an average hit in football. Below is a list of some of the ways brain injury can occur. If you begin to recognize yourself, hold an open mind—this injury has many faces.

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  • A difficult or traumatic birth, especially where heart rate or oxygen was affected such as a cord wrapped around the neck.

  • Premature birth

  • Concussions, even if symptoms appear to have resolved

  • Subconcussive trauma—injury to the brain that doesn't meet full concussion criteria

  • Car accidents (regardless of whether the head physically hits anything)

  • Air bag deployment

  • Sports: especially soccer, football, hockey, snowboarding, and waterskiing, as well as other sports such as baseball (fastball anyone?), rock climbing (falls even if the head doesn't physically hit anything), and cycling (being driven off the road or hit by vehicles).

  • Surgery—research indicates that anesthesia can have similar effects as a concussion

  • Hypoxia or loss of oxygen: this includes heart attacks, choking, and low oxygen during surgery or dental sedation. 

  • "Normal" childhood bumps and bangs (i.e. falling out of a highchair)

  • Chemo or radiation

  • Brain surgery

  • Brain tumors

  • Neurological conditions, such as multiple sclerosis

  • Childhood abuse and trauma (i.e. shaken baby)

  • Blacking out

  • Seizures

  • Chronic migraines

  • Falls

  • Assaults​

  • Bumping the head on common things such as car doors, cabinets, light fixtures

  • Things falling on the head

  • War (especially blast exposure)

Common Signs and Symptoms

While not a comprehensive list, below is a collection of common symptoms that together form the hallmark of brain injury. Even if your loved once cannot identify a cause, if a number or many of these symptoms are experienced, chances of a brain injury are high. Because  injury to the brain is cumulative, there may not be any one significant moment to point to but rather a collection of smaller incidents. Additionally, many insults to the brain are discounted or normalized in our culture—such as soccer, football, and auto accidents. The number of years that have transpired is immaterial—it all counts and adds up. My hope is the below list will help normalize what your loved one is experiencing, or even help you identify potentially what you or someone you know is navigating. 

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  • Photophobia (light sensitivity)

  • Headaches/migraines

  • Dizziness/vertigo/disequilibrium

  • Reduced balance

  • Sensory overwhelm

  • Difficulty reading or notable discomfort, pain, or headaches when reading

  • Visual motion hypersensitivity (especially riding in cars, being in a crowd, or people talking with their hands)

  • "Grocery Store Syndrome" (difficulty with visually and sensorially complex environments)

  • Difficulty with screens/computer vision syndrome

  • Unspecified Visual Disturbances (this unique to the individual, but is often seen with the eyes closed at night or at the point of exhaustion. This can appear as lines, colors, stars, fireworks, et cetera)

  • Slurred speech, especially when exhausted

  • Being or feeling less articulate

  • Brain fog

  • Mild to extreme exhaustion

  • Intermittent or persistent difficulty with finding words (often masked well with thoughtful pauses)

  • Taxed by conversating (this may cause exhaustion or even migraines)

  • Nausea

  • Difficulty reading (headaches, eye fatigue, nausea, reduced fluency, reduced word decoding or recognition, poor comprehension, flat expression, skipping words or lines, difficulty tracking, overwhelm with a full page of text...)

  • Reduced memory 

  • Hyperacusis (auditory sensitivity)

  • Difficulty scrolling

  • Symptomatic with high contrast patterns (such as black and white tile floors)

  • Symptomatic with patterned carpet (especially if colorful)

  • Reduced or poor depth perception

  • Avoids or fears escalators

  • Fear of heights

  • Avoids or fears elevators

  • Difficulty crossing bridges

  • Difficulty with light/dark patterns (i.e. sunlight through tree or the trusses of a bridge)

  • Avoiding driving on the highway

  • Double vision

  • Accidentally breaks things

  • Clumsy

  • Drifting to one side while walking

  • Leaning off center forwards or backwards

  • Startling easily (sometimes particularly on one side, or equally)

  • Reduced peripheral awareness (cars, people, or objects may appear to come out of nowhere)

  • Trouble timing crossing a road

  • Change in ability to spell

  • Change in facility with jigsaw puzzles

  • Change in navigational or directional skills

  • Head pressure

  • Discomfort, pain, or pressure in or around the eyes

  • Needing to ground or heighten proprioception (i.e. dragging a finger or hand along a wall, or suddenly wearing scarves, hoodies, or high neck shirts/sweaters). 

  • Disrupted sleep

  • Emotion dysregulation

  • Impulsivity

  • Depression

  • Suicidality 

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Less Common Brain Injury Symptoms Include:

  • Change in color perception

  • Change in taste

  • Change in temperature regulation or sensation

  • Stuttering, especially when tired

  • Feeling the nerves (i.e across the face, often related to the injury site)

  • Reduced or poor lymphatic drainage

  • Change in linguistic accent

  • Commotio Retinae (this can be caused by airbag deployment)

Let's Talk!

Schedule a consultation session and see if we're a good fit.
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