Wikipedia and Concussion

I am a lawyer, not a doctor. I carry no academic credentials as an author on brain damage. Yet, brain damage is all I do. All of my cases involve brain damage, and I interact with doctors on both side of the forensic bar, day after day. I can’t prove that it is true, but my guess is that more words of mine are read about brain damage and brain injury worldwide, than any other author. We get 50,000 visitors a month to our websites and our pages are linked on more than 6,000 other places on the internet. https://tbilaw.com is 4176 days old.

Yet, because I am a lawyer, my words only mean anything formally, when I am the one asking the questions, not doing the teaching. Despite this, years ago, I got involved in the definition of concussion on Wikipedia and was delighted that my non-scholarly words were allowed to guide people. If you have been reading this blog, you are well aware at the severe deficiencies in our medical approach to concussion, both from a treatment and a research standpoint. At least on the web, things could be better.

Well today I went back to Wikipedia, because a traffic report indicated that my page on concussion, http://subtlebraininjury.com was no longer linked there. What I found was a technically improved definition, with more than 40 references to scholarly treatment on Mild Traumatic Brain Injury. But alas, we now have a definition that is written by a committee, and a committee that has been too greatly influenced by insurance companies and doctors in their care, who are trying to fight the tide of growing understanding about brain damage following a concussion. Click here for Wikipedia’s definition of concussion.

I found these words there: “Diagnosis of concussion can be complicated because it shares symptoms with other conditions. For example, post-concussion symptoms such as cognitive problems may be misattributed to brain injury when they are in fact due to post-traumatic stress disorder (PTSD).[54] Injured people may suffer PTSD due to emotional trauma from the event, and cognitive effects of MTBI may impair a person’s ability to deal effectively with a traumatic event, potentially increasing the risk of PTSD.[54]”

This reads an awful lot like a defense neuropsychological report, and I can almost guarantee you was authored by someone who makes his living charging insurance companies $500 an hour to write 50 page reports, blaming every legitimate brain damage symptom on pre-injury psychological problems. So, I added my thoughts to the role of PTSD in brain injury diagnosis. It went up, and a minute later it came down. Someone named LeadSongDog, cut my additions, because he said it was unreferenced. Here is what was left:

I cut the following new para by User:Whipesq, as it was unreferenced:
However, PTSD is frequently over diagnosed in Post Concussion situations. Too many medical providers are using PTSD as a grab bag diagnosis to cover symptoms that appear to be more severe than the medical provider concludes they should be, based upon the verified evidence of concussion on the day of the event. Historically, PTSD is a syndrome that grew out of combat type stressors. Few, if any civilian injuries involve the same level of emotional shock (and hypervigilance) which accounts for the combat diagnosis. If, as discussed above, the concussion was under diagnosed on the day of the event, the symptoms may be consistent with a more severe injury than originally believed. The intersection of organic brain damage and emotional issue post concussion is a synergistic battleground within the mind, with both areas at risk for more severe symptoms, because of the interplay between the two. An area of study still in it’s infancy is whether brain plasticity, which has for generations been credited with positive gains in brain recovery, may be partially responsible for the poor recovery from PCS. The hypothesis here would be that during the early PCS period, the combination of cognitive difficulties, synergistically interacting with the stress and frustration of adapting to the trauma, rewires the brain in destructive ways.

The account had just been registered and I wouldn’t want to discourage a new editor. If someone can back it up with cites, some of it might be worth keeping. LeadSongDog (talk) 19:45, 7 March 2008 (UTC)

LeadSongDog is a physicist. I wonder where they taught about amnesia/PTSD/PCS in his education? I wonder if I could bring references from depositions of defense doctors?

I suppose it is fair. Wikipedia is supposed to be the people’s encyclopedia. I wonder how he got elected chair of one of the most important pieces of information on the internet?