Do Doctors Fail to Diagnose Brain Injuries?

Do Doctors Fail to Diagnose Brain Injuries?

The answer is YES!

Sometimes Doctors fail to catch brain injuries.  An example- Jack and Diane- two American kids growing up in the heartland- (apologies to John Mellencamp throughout)  have been in a bad car accident just outside the Tastee Freez where Diane works.  Jack is taken to the hospital by ambulance with complaints of back and hip pain.  Diane goes home but later that evening starts noticing severe head pain.  So she now goes to the emergency room.

Both Jack and Diane will see a triage nurse who will be interested in and record their complaints.  In Jack’s case the immediate focus will be on Jack’s back and hip pain.   Diane, because she reports severe headaches- will have the focus on her head.

Jack will later be seen by a Doctor who will likely order x-rays of his low back and hips to try to assess what is going on for purposes of a diagnosis and treatment.

Diane will be seen by a Doctor who will evaluate the headache complaints and may order an scan of her brain to look for some type of brain trauma.

Now watch what happens.  Jack’s back and hip problems are diagnosed as fractures and he is admitted into the hospital and given pain medicines.  The pain medicines may mask signs of a traumatic brain injury.  And he may continue on those pain medicines long after he is discharged from the hospitial.  Weeks later he comes off of the pain medicines.  His football coach notices he is shorter tempered than before-and he just doesn’t seem to remember the plays as well.  Will this mess up Jack’s plans to be a football star?  Maybe it’s still the back injury, the coach thinks.

 

In Diane’s case the brain scan came back “normal” and the headache resolves over the many hours she is in the emergency room.  The Doctor discharges her and tells her to see her primary doctor if she develops “worsening symptoms”.  Over the next weeks she is noticing some mild headaches and work seems to be more difficult.  She can’t miss work.  She may get fired.  It may just be problems with her new boss at the Tastee Freez, she thinks.

 
 
 

In both of these examples a traumatic brain injury could be responsible but has gone undiagnosed.  Numerous medical studies report a delay in treatment can negatively impact the outcome.

 
 
 
 

About 1.7 MILLION people suffer a traumatic brain injury each year in the United States alone.  Almost 80% of those – 1.365 million are treated and released from an emergency room.  According to the Center for Disease Control and Prevention (the CDC) “ In general, total combined rates for traumatic brain injury (TBI)-related emergency department (ED) visits, hospitalizations and deaths have increased over the past decade,” [2001-2010 statistics].  Traumatic Brain Injuries result from many different type of events.

 

It is important for friends, family to be vigilant for the potential of a traumatic brain injury.  The patient may very well not be aware of the problems.  Things to look for according to the Mayo Clinic include:

For milld traumatic brain injury the signs and symptoms may include:

  1. Physical symptoms
    • Loss of consciousness for a few seconds to a few minutes
    • No loss of consciousness, but a state of being dazed, confused or disoriented
    • Headache
    • Nausea or vomiting
    • Fatigue or drowsiness
    • Difficulty sleeping
    • Sleeping more than usual
    • Dizziness or loss of balance
  2. Sensory symptoms
    • Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell
    • Sensitivity to light or sound
  3. Cognitive or mental symptoms
    • Memory or concentration problems
    • Mood changes or mood swings
    • Feeling depressed or anxious

For Moderate to severe traumatic brain injuries may include any of the signs and symptoms of mild injury, as well as the following symptoms that may appear within the first hours to days after a head injury:

  1. Physical symptoms
    • Loss of consciousness from several minutes to hours
    • Persistent headache or headache that worsens
    • Repeated vomiting or nausea
    • Convulsions or seizures
    • Dilation of one or both pupils of the eyes
    • Clear fluids draining from the nose or ears
    • Inability to awaken from sleep
    • Weakness or numbness in fingers and toes
    • Loss of coordination
  2. Cognitive or mental symptoms
    • Profound confusion
    • Agitation, combativeness or other unusual behavior
    • Slurred speech
    • Coma and other disorders of consciousness

Infants and young children with brain injuries may lack the communication skills to report headaches, sensory problems, confusion and similar symptoms,” According to the Mayo Clinic.  Below is a list of symptoms to be aware of:

  • Change in eating or nursing habits
  • Persistent crying and inability to be consoled
  • Unusual or easy irritability
  • Change in ability to pay attention
  • Change in sleep habits
  • Sad or depressed mood
  • Loss of interest in favorite toys or activities

If you are someone you know has some of these symptoms or you suspect a traumatic brain injury get help- seek medical attention and make sure the Doctor or other health care provider is made aware of your concerns.