Head trauma: mild vs. severe

F. Frank LeFever flefever at ix.netcom.com
Thu Jan 23 22:51:35 EST 1997

In <5c7omr$r4m at newsgate.duke.edu> <stump002 at acpub.duke.edu> writes: 
>What are the differences between mild brain damage and major apart
>movement and speech. I could be a volunteer, but I myself don't know
>extent of my own brain damage. 
Mild/moderate/severe are very loose terms.  I have been focusing on
"mild" in the sense that the complaints of some patients, continuing
sometimes months or years after a blow to the head, seem out of
proportion to what seemed to be the immediate effects.  In this sense,
such a person may have been unconscious for less than an
hour--sometimes it seems for only a few minutes or even less.

They may be quite capable of going directly home from the ER (if indeed
they sought treatment at all), and although maybe a bit "fuzzy" are
aware of where they are, where they are going, what has happened
(although perhaps not remembering the actual blow).  They may have
headache, then or a few hours alter, etc.

At the other extreme, unconsciousness may last hours, days, or weeks
(i.e. "coma"), and even when they waken may not be able to remember
from day to day what is happening (post-traumatic amnesia).  They may
have severe motoric problems--may need to relearn how to walk or may
never be able to again.  They may have greatly reduced cognitive
ability, finding normal everyday tasks nearly impossible.  Etc., etc.

Between these extremes, are of course those with "moderate" injury.

In other words, I am using loose categories based on symptoms and
behavior, not on what a CT or MRI shows  (i.e. visible amount of

With appropriate rehabilitation programs, and much time, many with
moderate or even severe injuries are able to enjoy some return to
normal activities at some level or other.  

People with MILD injury are often aware of day-to-day fluctuations in
problems with concentration, memory, "energy", etc., and complain that
at least on the worst days severity is enough to make work at their
pre-injury level nearly impossible or require much more than usual

There is the IMPRESSION of a paradox: that those with mild injury
complain of such things more than those with moderate or severe injury;
but it it true?  Is it a matter of those with severe injury having more
"serious" and "objective" problems to worry about?  Or is there
something physiologically different about recovery mechanisms that
makes for differences in these more "subjective" symptoms?

SO, I am asking for personal testimonies from those with ANY degree of
injury (but tell me which degree), or from family or friends, or from
professionals working with them.

REGARDLESS of your degree of injury or type of symptom, it it varies
from day to day, being a really significant problem one day but not
qite so serious another, I am interested in your sending me a day to
day rating: worse, better, or same as usual?
            worse, better, or same as day before?

Tell me also age, sex, and geographical location (postal zip or phone
area codde will do), any other useful info (e.g., more than one blow to
the head? when?).

I don't want ratings influenced by what ratings others send, so do not
post in newsgroup: e-mail directly to me.  OR, snailmail to:
                                               Monitoring Project
                                               Box 199
                                               Thiells, NY 10984 USA

Frank LeFever
New York Neuropsychology Group

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