Concussion and other brain injuries
Concussion and other brain injuries are an important issue for everyone, not just for athletes and the military, but sadly when someone seems to function normally physically, the potential for injury often gets disregarded, and is clearly misunderstood in terms of both short and long term effect. While CT and MRI are wonderful tools for looking at brain anatomy (they rule out things like bleeds, tumors and fractures) and can be done fairly quickly, they tell little about brain function. EEGs and Neuropsychological testing will tell the more subtle information about brain function gone awry, but are a bit time consuming and unwieldy for ER use, and the EEG is only as valuable as the skill and experience of the person reading it.
However, with the analytic technology available today, returning to the world of ‘Brain Mapping’, which is using an EEG (brain wave test) displayed as a map and then compared to normative date, would seem to be the ideal solution. It was a useful tool in the 80’s and 90’s when used in the hands of those willing to take time to study and analyze, but it took time because just looking at the ‘maps’ was only part of the task, the insurance companies didn’t want to pay for it, and there was argument about the ‘normal data bases’ – (which were probably far superior to what is looked at in reading routine EEGs and doing pharmaceutical research). With the Neuroscience system and teamed up with an incredible Neuropsychologist (Ken Bonnet) at NYU, we were able to not only diagnose and then confirm, residua of closed head injury – both fairly new and remote – but unsuspected endocrine problems, infections, an aneurysm, and missed low grade seizure disorders, particularly in the temporal lobe area (and often a residua of CHI that causes mood swings).
The EEG, combined with today’s rapid computers and the ability to analyze complex data quickly, and augmented with the ability to ‘map’ abnormalities, could take this tool light years beyond the dreams of Hans Berger who developed it (and could predict people’s personalities based on it) and Roy John who hoped for a quick and easy way to make psychiatric diagnoses. It could go far in better understanding the whole function of the brain and where things go awry and give better guidance about where to fix things. In looking at the history of psychiatry, so many ‘mentally ill’ people were cured when their underlying medical issues could be diagnosed and treated (think seizures, brain tumors, strokes, TB, Syphillis, Thyroid and other endocrine disorders, medication effects and so on.) There are so many physical things that can effect both physical and emotional function of the brain, that this is a tool which should have already come about to augment the histories and physicals that currently are usually done so inadequately and the ‘inventory scales’ that are so limited in their scope.
I write this in hopes some of you MIT Techies out there will pick up this ball and run with it!!!