Issues of Advocacy

by Attorney Gordon S. Johnson, Jr.

A friend asked a group of us, what issues the brain injury community needed to focus more upon. My response:

A. The Brain Stem.

Just when I think I am starting to know this stuff, I run into a whole new area of my own ignorance. Too often, as I learn about the new area, I find a whole new category of injury that most medical professionals don’t diagnose.

The Brain stem is the area that may be the least understood. Injury to the brain stem and the cranial nerves which run off of it could explain so many subtle problems which don’t profile on neuropsych testing and are too often ignored by even specialists in brain injury. The brain stem is the part of the central nervous system that is between the spinal cord and the brain, and like the spinal cord, it has nerve roots branching off of it. These nerves are called the cranial nerves and control the muscles and senses contained in the head, such as sight, hearing, taste, balance and your smile.

B. MS and Trauma.

MS cannot be caused by trauma. But MS can and does go from asymptomatic to symptomatic as a result of trauma. There are three basic premises to this theory:

1. 50% of the people who have MS are asymptomatic (meaning without symptoms of the disease), throughout their lifetime;
2. A person with MS does not become symptomatic until there has been an alteration in the blood brain barrier;
3. Trauma causes an alteration in the blood brain barrier.

If the person was asymptomatic before trauma, and became symptomatic after, it can be established that the activation of the disease was caused by the trauma.

C. Ethics of Rehab and Service.

Neurosurgery, better scanning, intercranial pressure monitors and flight for life are performing medical miracles, saving lives that would have been lost. But the doctor must learn that saving the heart beat, if the person is lost, is not a miracle. We must make them accountable for the heart beats they have saved; to realize that once they have taken this step, they cannot stop when the survivor awakes. They have an obligation to restore quality of life, not just for the survivor, but also to the community they seek to return the survivor to.

NEXT: Boy Who Could Not Remember.

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