When brain injuries occur, they are rated on the Glasgow Coma Scale. The rating does not indicate the severity of the long term outcome. It only applies to the initial trauma. Even a brain injury with brief loss of consciousness or no loss of consciousness can cause permanent disability.

No blow to the head

Brain injuries which occur with no blow to the head often go undetected until much later when unexpected symptoms appear. Even then, they may be misdiagnosed because neither the victim nor doctors suspect that brain injury is involved.

More than half of brain injury survivors develop epilepsy within the first year after injury. Undiagnosed epilepsy poses a substantial risk of second impact syndrome, due to the increased likelihood of accidents.

Brain injuries can occur with no blow to the head in auto accidents and sports accidents due to rapid acceleration and deceleration. The tissues and nerves in the brain can be stretched and torn, and the brain can impact the inside of the skull. Shaken baby syndrome is another example of brain injury with no impact to the head.

Brain injuries worsen over the first three days

Regaining consciousness after a blow to the head does not always mean that you are on the road to recovery. In fact, many patients have worsened significantly the day after their injury.

Brain cell death continues to occur for up to 72 hours after the initial injury. Bleeding and swelling are sometimes detected, but ionic changes which cause damage on the cellular level do not show up on imaging tests.

Most patients do not seek follow up medical attention, even if their symptoms worsen. Because they do not seek medical attention, their medical records do not reflect the severity of their symptoms, and most are not warned of the long term effects which they may experience.

Living with "mild" brain injury

The long term effects of mild brain injury can be severe and debilitating, and because the injury is referred to as being "mild" most patients are not prepared for the symptoms when they appear. They may not even notice the symptoms themselves. Often it is friends, loved ones, or coworkers who first notice symptoms, and they may not be aware of the cause.

Amnesia is common after mild brain injury, and amnesia is usually not a total loss of memory as it is portrayed in the movies. Post traumatic amnesia (PTA) occurs when the brain cannot form new memories. In the first few days or weeks after brain injury the victim may seem perfectly fine, but unable to remember conversations or obsessed with recounting the details of the accident over and over to the same people.

Unexplained anger, radical mood swings, extreme fatigue, and apathy are all common effects of mild brain injury which may be misinterpreted and can lead to severed relationships, lost jobs, and even legal problems.

Brain injury victims need love, support, and patience from those around them. Recovery can happen quickly, but it can take several months or several years. Some people never fully recover.