Subtle Brain Injury©

The absence of a significant or identifiable period of loss consciousness does not mean that an injured person has not suffered a permanent brain injury. Likewise, permanent brain injury can occur without a person having hit his or her head. While seemingly not as dangerous as injuries involving coma, hematoma, and surgery, these injuries can be life altering, and in some cases as disabling as many coma injuries.

The American Congress of Rehabilitation Medicine’s definition of mild traumatic brain injury is one of the most important pieces of information to change our understanding regarding the potential severity of brain injury without a significant period of unconsciousness. While such definition still uses the term “mild” traumatic brain injury, it establishes clear cut authority for the premise that these non-coma type injuries can be serious and permanent. Such definition, establishes that a permanent brain injury can occur if any of the following four conditions occur as a result of trauma, or accident:

1. any period of loss of consciousness;
2. any loss of memory for events immediately before or after the accident (amnesia);
3. any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused); or
4. focal neurological deficit(s).

[Source: Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine, published in J Head Trauma Rehabil 1993:8(3):86-87]

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Understanding Subtle Brain Injury

The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.

View Our Video Series on Concussions