Traumatic Brain Injury: The Invisible Injury

Traumatic Brain Injury (TBI) is not like any other injury. Sadly, because many of the symptoms of "mild" to "moderate" traumatic brain injury are subtle, and because the injury commonly avoids detection on our most sophisticated hospital imaging equipment, it is common for victims to go undiagnosed. This is especially so in the emergency room.

"Left to fend for themselves, the victims of traumatic brain injury, already confused by their inability to be the people they were prior to the injury, now face the daunting task of demonstrating that an injury they do not understand and cannot comprehend is producing the confusion they cannot communicate."

Due to the invisible nature of the injury, victims of traumatic brain injury only rarely receive prompt treatment for their physical and cognitive impairment. Not uncommonly, victims' early medical charts are devoid of any mention of "head injury" or "cognitive impairment". It is only later, if lucky, that a health care professional validates the victims" injury, and treatment finally ensues.

As with most misunderstood injuries, society and "old school" health care practitioners, are apt to label the TBI victim a malingerer, or worse. Because victims of traumatic brain injury appear outwardly just as they did before the injury, it should come as no surprise that many victims describe their post-injury experience as including progressive social isolation together with alienation from even immediate family.

Practically, victims of TBI are unable to process information at pre-injury rates of speed. Nor is the range of subject matter about which an individual can think the same for a victim of traumatic brain injury. Accurate judgment becomes difficult, at best. Communication is oftentimes stifled, and the ability to conform behavior is impaired. Violent behavior may manifest as a result of frustration and inability to respond in a pre-morbid (pre-injury) manner. Headaches are common, and smell and taste can be affected. Memory and recall are often times profoundly affected.

Conscious or unconscious awareness of the situation becomes the private "hell" of the victim, who is alone and unable to diagnose or resolve the injury. Describing this unfortunate circumstance, Dr. Antoinette R. Appel has stated: "Left to fend for themselves, the victims of traumatic brain injury, already confused by their inability to be the people they were prior to the injury, now face the daunting task of demonstrating that an injury they do not understand and cannot comprehend is producing the confusion they cannot communicate."