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[Neuroscience] Re: Did I damage my prefrontal cortex?

JHasenkam from gmail.com via neur-sci%40net.bio.net (by JHasenkam from gmail.com)
Mon Jan 28 19:02:58 EST 2008


On Jan 26, 7:31 am, chadmaester <chad.d.john... from gmail.com> wrote:
> On Memorial Day, 2004, I was riding my bicycle down the street, and,
> stupidly not wearing a helmet, I hit my forehead on a concrete
> sidewalk after not making it around a corner. I was going 5-10 MPH.
> The impact broke the skin and left me with about a 3-inch scar down
> the middle of my forehead, starting about 1/2 above me hairline (seehttp://chadjohnson.ath.cx/scar.jpgfor a picture). I needed 19
> stitches for that. When I hit the sidewalk I rolled to the right once
> or twice, bumping the right side of my head (hard enough to leave a
> scar) 1 inch above my ear but toward my face between my ear and my
> temple. I believe I had a slight concussion.
>
> I also have a pretty good bump in the bone of my skull that is about 1
> inch wide and maybe 3 inches high. I am not sure whether this was
> there before the incident or not (is this likely to be a result of the
> accident?).
>
> I do know that my behavior has become more aggressive and cynical
> since, but I am not sure whether this is a result of my departure from
> my Christian beliefs (and cynicism toward them; no, I wish to not talk
> about Christianity here). Also, I am a college student, and I have a
> hard time getting up in the mornings and getting to classes on time. I
> also find that I have had a poor short-term memory (e.g. ADD-like; I
> have a hard time staying in context in conversations), and I often
> have a hard time focusing at work (I am a computer programmer) and get
> distracted very easily by email or people coming up and talking to me.
> Furthermore, I have a hard time reading books and staying in context
> and not getting distracted (namely daydreaming)--but I do know I had
> somewhat poor reading comprehension in middle school. Again, I am not
> entirely sure to what extent these behaviors were present before my
> accident, but I believe they were present at least to a lesser degree
> than they are now.
>
> So, I am wondering two things: 1) how likely is it that I damaged my
> prefrontal cortex (or any other part of my brain); and 2) if I did in
> fact damage my brain, how bad does the damage sound?

There is a distinct possibility of damage occurring here, particularly
if the impact involved a twisting of the head at the time of impact.
This type of injury can be very difficult to detect so if a clinician
does one imaging and says no damage don't take that as gospel. Your
symptoms do suggest some level of damage. It might be self limiting,
over time these might recede but ideally you need to find a good
neuropsychologist who is familiar with mild brain injury and subtle
changes it can induce in behavior.

Possibly not just your pfc, the contrapoint might be relevant but also
the VTA afferents to the frontals are easily damaged and it can be
very difficult to detect these lesions.

You need to do the following;


Ask people who have known you if they have observed any changes in
your behavior. Don't tell them why you are asking, be subtle, no
leading questions, and ideally elicit such observations without direct
questioning.
Have some imaging done but don't take a null finding as conclusive.
Some neuropsych tests, particularly those designed to measure pfc
function, is a good idea.
Find good clinicians who will take your reports seriously. If a
clinician says the imaging shows no damage and considers that the end
of the matter walk out the door and don't pay the bill.
Don't accept recommendations for drug intervention, in your case this
is not a good idea.
Changes in diet and lifestyle can aid recovery, if you have a positive
diagnosis then you should consider seeking advice in changes to
maximise brain repair.

Remember, a great many people are in the same boat and it is not
uncommon for such injuries to go unnoticed. So if you are convinced
something has changed you may need to persevere until you find a
clinician who has experience in treating such injuries and takes your
statements seriously. As you are studying I would consider addressing
this problem as a priority. Your symptoms probably won't get worse but
therapy might also be able to reduce the symptoms.




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