Posted on August 30, 2011 · Posted in Brain Injury
  • Does Mild Traumatic Brain Injury (MTBI) involve permanent brain damage? It can.
  • Does MTBI result in disability? Often, but usually not for extended periods.
  • Will you get better if you are feeling the effects of a concussion? In all likelihood.
  • If you don’t have a full recovery, is it because you are nuts? No.
  • Why is it that some people continue to have persisting problems after suffering a mild brain injury? That is what we hope to help you understand here.

Too much of the focus in the study of what is called “mild” brain injury, is in predicting how serious a brain injury will become, based upon the way in which the patient interacts with medical professionals on the day of the injury. This misses the point. While, if there was no concussion, there will be no mild brain injury. But once there has been a concussion, the focus should be on  on what deficits the person is left with, after a healing period, not on categorizing the seriousness of the concussion. Next, the focus should shift to what can be done to minimize the disruption of those symptoms upon the mild brain injury survivor’s life.

To begin, we will explain why some people have “apparent full recoveries” while others are profoundly impacted by what appears to be a similar injury? To begin, we summarize our theory of the pathology of mild traumatic brain injury.

  • Diffuse Axonal Injury. Concussion or MTBI results in organic injury to the brain.  Much of the injury is through the mechanism of shearing, causing diffuse axonal injury. Two complex terms/concepts we will talk much about later.
  • MTBI Involves a Process of Injury not an Event. This injury is more likely as a result of strain to axons than actual tearing, which over the first 72 hours results in a cascade of events which can disrupt a significant number of neural connections.   The axons are assaulted by neuro-chemicals allowed to go where they shouldn’t, which can cause death or damage to the axons.  The axons are the long stringing part of the neuron’s which interconnect neuron’s with each other.
  • Brain Regeneration isn’t Total Recovery. Our current research into neuropathology indicates that significant regeneration of damaged neural connections can occur.   But the extent of such regeneration falls off considerably after age 40.  Further, regenerated neural connections are less efficient than such connections are naturally.
  • Concussion Can Hit High Achiever’s Hardest.  As axonal injury is predominantly an injury which disrupts the efficiency and speed of neural connections, individuals in professions which place a high demand on processing speed, are more likely to experience deficits.  Thus, in such a profession most professionals who have suffered more than a Grade I concussion, will notice material change, when sufficient demands are made upon the brain.

Understanding Mild Brain Injury

There is an overwhelming ignorance that there is even the possibility of permanent brain damage in patients who may have suffered a concussion. Much of the medical community still believes that there can be no permanent brain injury without a loss of consciousness.  Likewise for a the need for a blow to the head. Perhaps more important, there is a weak grasp that brain injury symptoms escalate after the first couple of hours. There is also far too much confidence put in our ability to rule out brain injury through the use of CT and MRI.   For more information see

About the Author

Attorney Gordon S. Johnson, Jr.
Past Chair Traumatic Brain Injury Litigation Group, American Association of Justice :: 800-992-9447