For mild TBIs, making a clear diagnosis can be difficult. There are CT scans and physical and neuropsych evaluations. But in the future there may be simple, revealing blood tests.
This is an excerpt from BrainLine's webcast After the Injury: Acute Care and TBI. See full webcast here.
About the author: Jeffrey Bazarian, MD
Dr. Bazarian is an emergency physician with a strong research interest in traumatic brain injury. He is associate professor of Emergency Medicine, Neurology, and Neurosurgery at the Center for Neural Development and Disease, University of Rochester Medical Center.
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Deb Jaeger replied on Permalink
My adult daughter has been diagnosed 7 years now with Encephalomalacia. She has sustained 2 additional head injuries. The 1st being August 5, 2017. The 2nd and more severe occurred September 14, 2017, when she lost consciousness and dropped to the floor from a standing position. She hit her head & VP Shunt, & her neck on a steel stool & her spine hit the floor. They did a sternal rub to bring her back aware. She gasped coming back claiming she initially couldn't feel her legs. A CT Scan of head & neck was done within 1 hour. No spine evaluation. Then maybe an additional CT head 24 hours later. However, my daughter's head injury was severe enough to cause immediate vision decline in an already existing 3 TBI related Eye Disorders: Exophoria, Accomodating Disorder, & Convergence Insufficiency. That 2nd head injury resulted in at least a decline in her Accomodating Disorder. On October 3, 2017, her Neuro-Opthalmologist confirmed with a cursory simple exam determined a decline in her Accomodating Disorder. He stated it could upwards of 1 year for any improvement. He stated in his narrative that he did not think based upon his exam, that she has increased ICP, however her ICP could be mild to moderately high. Now, here's MY thought. There are TESTS to determine this. Right?
There was a recent return visit back to him. This time I made requests for tests to determine what in her brain was injured to cause the vision loss. We waited to be seen from 3:45 pm until 6:30pm that evening. My daughter in pain was in & out of her agitative state. When he came in to see her he didn't examine her..but I know he surely read the nursing notes and my requests for testing. He said, " We can give her a first appointment at a future date." As of today, no tests have been done on her brain since her last CT Scan September 15, 2017. My daughter has also a 10 year history of her VP Shunt in overdraining status. I just reviewed records ibdicating this. It was found blocked the 1st week of August, 2013. Its been in place since October 19, 2007. The last 3 settings on the Medtronics Strata 2 VP shunt were ruled out. The 1.5 for overdrainage. The 2.5 ruled out for contributing to cyst formation. The 2.0 was ruled out for overdrainage. It appears too, the proximal catheter was placed in the most unfavored spot. There are 4 placements, her proximal catheter terminates in the Genu of Corpus Callosum. Repositioning this catheter was considered when it was found blocked causinv right ventricle edema, frontal lobe edema. Then she was sent home with no repositioning. Her Encephalomalacia occurring has 1st multiple head injuries
(+10), she is also a Chiari Malformation patient. She has had 2 decompression surgeries. 1 shunt placement, a surgery to resolve a huge Pseudomeningocele right after her2nd Chiari decompression revision. So multiple layers. Amazing that she is still having some good days with intermittent agitation with aggressive tendencies. She is in alot of pain which is not being treated. I would appreciate any helpful suggestions as nobody is giving me any answers.