Diagnosing Brain Injury – What More Needs to be Done

Diagnosing Brain Injury – Changes in Protocol Needed

By Gordon Johnson

Call me at 800-992-9447

Improving the protocols for diagnosing brain injury is one of the missions of my career. As an attorney and not a doctor, that might seem an unrealistic goal.  But because of the web, my words of brain injury advocacy have been read hundreds of thousands of time. In contrast, the best book on the shelf behind me sold only a few thousand copies. If my writing makes my credentials as a neuroscientist, self accrediting, then perhaps my words can have an influence.  Thus, I continue to tilt at these windmills.

If diagnosing brain injury is not done acutely, the time to intervene may be lost. Thus, we will start our treatment of diagnosing brain injury, with a discussion of Amnesia.  We start with Amnesia not because it is the most permanent of conditions, but because it is the most transient. Identifying and documenting its existence is the single most important step in identifying the severity of all brain injuries.  Identification of the existence of amnesia can help to distinguish the disabling brain injury diagnosis, from a ding or simple concussion.   Within our operating manual for the mind analogy, amnesia is the clue that you are about to lose what you have not saved.

Yet if we think about the brain strictly like a desk top computer, we will not grasp the subtleties of amnesia.  Unlike a power cord dependent computer, the brain can save islands of memory, in seas of amnesia. The brain’s Save Button is not an all or nothing process like it is on our computer.  Physiological and emotional processes around the time of an event may be intense enough to push the memory through a bottle neck of cognitive inefficiency to the long term storage device.

Assume that your memories were coming to your hard drive, through a slow internet connection.  We know that when the connection slows down, all data transfer is delayed.  But assume that Google, in its mighty power, found a way to prioritize Google data so that its search results would jump in front of all other demands on the bandwidth.  That is what certain memory stimulants can do, even when your brain’s ability to record memories is severely impaired by concussion.

After we cover amnesia, this treatment of diagnosing brain injury will focus on how the brain works. We will do this as a prelude to understanding how injury pathologically changes brain function. Our effort at to improve diagnosing brain injury will then focus on diffuse brain injury, primarily injury to the brain’s white matter, the brain’s the axons and axonal tracts. The impact of such injuries can be the equivalent to a dramatic drop in speed and reliability of the way in which a computer would process information.

To help in conceptualizing diagnosing brain injury, we will also discuss the “footprints of pathology”. While  footprints of pathology is my term, it does describe the traditional diagnostic methodology which try to find proof of the brain’s malfunction as objective evidence in diagnosing brain injury.  The use and misuse of neurological exams and technological tools, such as CT, MRI and EEG will be discussed.  We will show how these tools are capable of seeing footprints of pathology yet miss the fingerprints of pathology because of the deficits in their macroscopic/static analysis.  Neuropsychology, which is the most highly regarded of these diagnostic for diagnosing brain injury, will be discussed later on.

Understanding Focal Injury – the Big Stuff

Elsewhere in these pages, we have focused on severe brain injury.  That focus is on the “big stuff”, focal injury impacting large and specific brain structures. Our treatment of severe brain injury starts with horror of a family coming to the Trauma Center with no more prognosis than “we will just have to wait and see?” days and weeks of waiting. Click here for Brain Injury Coma Help for Families.

From that beginning, we then address an overview of severe brain injury. To help with the understanding of severe brain injury, we provide a lesson in the the normal anatomy of the brain. Click here for those pages.  With those premises, we believe the user who needs our help, has the knowledge base to understand severe brain injury neuropathology. Click here for the neuropathology of severe brain injury.  One of the principal differences in the way my writing for the web than it would be in a book, is that the linked menu’s allow the family member or brain injury survivor to focus on the information they need in the sequence they need it. This specific page on the treatment of diagnosing brain injury may be too much or too slow in terms of the information you need. At anytime, you can look to the menu’s on the right for more specific information.

Now – Post-Traumatic Amnesia


Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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