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Some of the saddest cases that I have worked on have been cases that involved traumatic brain injuries. These cases are always difficult because not only are these injuries hard to prove without the aid of very specific and specialized medical testing and testimony, but because they can go undetected for long periods of time, following the actual injury.

In fact, many times, it isn’t even the person who has suffered the injury who will first notice the changes that it has caused. It will be family and friends who will notice your memory slipping or that you may not be speaking as fluently as you once did. Worse, it may be your boss that realizes your work production and accuracy has suddenly dropped.

To understand why this is the case, we first have to have a grasp of how these injuries occur and what they involve. I will do my best to explain in as simple terms as possible.

What is a Traumatic Brain Injury?

A traumatic brain injury occurs when there is a trauma or impact shock delivered to the brain itself. The results of this “insult”, as physicians term it, can be greatly varied both in its effect and severity, but suffice it to say that its effect can range from a simple concussion to a coma and may affect any or all of your cognitive abilities or reflex reactions.

In simpler terms, it can affect any function that your brain performs.

How Does a Traumatic Brain Injury Occur?

This is where it can be a little complicated because it involves both physics and the anatomy of your brain.

We will start with the physics part. Objects at rest tend to stay at rest. Objects in motion tend to stay in motion. These are the first laws of motion or inertia that most of us learned in school.What they mean is that an object wants to continue whatever it is doing.

Now, say you are in your car, you’re travelling down the road and your car gets rammed from the side or you are sitting at a stop light motionless and you get hit from behind. Your car, body, head and brain have to absorb the impact and change their state of motion, but because they all differ in mass they don’t move as one, but each according to how and when the energy reaches it. That is where the term whiplash comes from. The energy tends to travel through the body the same as through a whip being cracked.

Unfortunately, the brain is the last to receive and recover from this sudden change of state. The result is that the brain floating around in its container of fluid will be moving in the wrong direction at the wrong time and may actually strike the inside of the skull and become bruised.

The more sinister possibility is that because the brain is actually made up of two different types of matter, each with a different density, that the two parts of your brain will not move as one with the resulting shearing action damaging the microscopic nerve connections that tie the two together this is technically called a diffuse axonal injury.

.This is the damage that is so hard to find because it actually happens at a cellular level and will not show up on regular radiological exams.

What You Should Do

If you have been in an accident that included any type of head trauma, even a sudden change of motion that may have resulted in an unrecognized traumatic brain injury, ask your treating physician to run diffusion tensor imaging (DTI), SPECT scan (Single Photon Emission Computed Tomography) or another appropriate test.