Concussion: Diagnosis Dangers

2018-04-10 • SEND FEEDBACK •
Related: concussion, health

Legal disclaimer: Since we are not doctors, never follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional. OTOH, the study of brain injuries is at best in its infancy, like studying outer space with primitive telescopes.

This page contains important findings based on my own personal experience.

Thank you to supportive readers, and especially my loyal subscribers. The latter are critically important to me as I recover, and I am grateful to them. I also want to thank OWC / MacSales.com and B&H Photo for their ongoing support as I work through this.

Direct head impacts are NOT the only cause of concussion

Do not assume that a concussion has to occur with direct head impact. In my case, the 10-day-old helmet showed no obvious clues that it had ever impacted anything. And yet my symptoms showed severe “brain slosh”. It is the deceleration that causes the yanking and small internal tearing, including contra-coup effects (those opposite the first decelerative impact).

I have no recollection of hitting my head (since I was unconscious for some indeterminate time). The brain sloshes within the skull with sudden deceleration regardless of direct impact—and I flew straight through the air at 25 mph into a soft soil/grass embankment, skidding a few feet perhaps but with no scraping or anything to slow me—so I hit it very hard. That’s a rapid deceleration, and so even without a direct impact to my skull, my brain experienced similar deceleration forces as with my body upon impact.

Struggling into the Solvang Cottage Hospital about 2 hours after my crash, I was moving slowly and had already suffered several emotional breakdown fits—classic signs of concussion. My speech had partially recovered, but it was slow and tentative and I was not very attentive, being groggy and out of it. I remember telling the attending physician that I was concerned about internal bleeding due to abdominal pain and a CT scan was done for that. I also said that I did not think I had hit my head but ALSO that I had hit with hard impact flying through the air at 25 MPH. Yet no evaluation for concussion of any kind was done! Is a wobbly drunk claiming he’s had not drinks to be believed? Doctors must not take trauma patients at face-value but must use their brains! This doctor failed to do so.

In retrospect, I was exhibiting all the classic signs of concussion, so I can only say that this was not very good evaluation there down in Solvang. no doctor should take a wobbly half-coherent patient’s statement as a working assumption. That incompetence put me at great risk, and sent me to the ER a second time, 5 days later.

Lack of diagnosis leads to further damage

The lack of any concussion evaluation sent me away not realizing that the injury was actually quite severe. It was my short 45 min easy bike ride of March 21 that sent me into the Stanford ER 5 days later (March 22); this apparently overloaded me (and exhausted me too): I awoke with a pressurized skull and notably impaired cognitive function.

I had sense enough to realized that I was badly impaired, so I had my wife rush me to the ER, fearing the worst (cerebral edema or brain bleeding). Shortly upon arrival:

• I broke down emotionally into a crying fit.
• I had trouble remembering very simple details, taking a minute or so to answer.
• I thought it was very kind of a nurse to hold my hand. I didn’t realize for 15 minutes or so that the nurse was my wife.
• I was severely cognitively and emotionally impaired.

The attending physician stated that I had a severe or at least moderately severe concussion. This seemed right, but the discharge papers stated (quite absurdly) that I was fit to return to work the next Monday, 4 days later. This I think was very, very poor judgment, as this was clearly not the case, including 3 weeks later!