Posted on January 2, 2008 · Posted in Brain Injury

A rose by any other name….

The medical community has always had labels for brain injuries, including the mild, moderate and severe classification, as well as coma and post concussion syndrome. None of these labels recognize the severity of all permanent brain injury.

Mild. But would a “mild” brain injury, by any other name, still be so ignored? Mild is a 75 degree day, a southerly breeze. Mild is not a day with only partial light, where the temperature fluctuates wildly, with unexpected torrents and lightning strikes. Mild does not imply a permanent alteration in who a person is.

Concussion. How about concussion? A concussion implies a transient wave like disruption, a disruption that shortly returns to normal, like a drum or a cymbal after the sound fades. But our minds are not musical instruments that are tuned for vibration. They are jello like masses, containing nerve cells with little or no elasticity. We do not become dazed and confused because the jello in our skulls is vibrated, we do so because our brains come into contact with a hard object, the skull, or because the acceleration and deceleration in this mass, twists these nerve fibers as surely as an ankle is sprained or broken, a muscle torn. But unlike a muscle which can freely swell until the pathology heals, our brains have no room to expand and no tolerance for stretching and tearing. Brain cells do not regenerate.

Post Concussive Syndrome or PCS. Post concussion syndrome, or PCS, isn’t much better. I hate labeling anything a syndrome. A syndrome implies some conglomeration of symptoms, that can’t actually be identified as a real disease. If concussion understates the acute injury, labeling a persistent concussion a syndrome implies it is something we aren’t quite sure is real.

Further, PCS has gotten to be a catch all for all those things the doctors don’t know what else to call. Brain injury without coma involves so many different types of pathology, it is misdirected to label them all concussive, and lingering problems, post concussive.

Non-Coma Brain Injury. Why not just brain injury, not mild, moderate or severe, but brain injury. Is the term too harsh? Does it offend someone’s politically correct sensitivities about labeling people? Someone please think of a better term for “permanent brain injury without coma”, but until they do, I will stick to brain injury – for that is what it is, non-transient, permanent alteration of the way in which the brain absorbs and processes information and thought.

PCS, Mild, Non-Coma Brain Injury = Damage to Our Minds.

About the Author

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