quote:

I don't suppose I will ever know if there have been more subtle changes due to that injury. How can you tell if having trouble with stress is the result of PTSD alone, or is augmented by some effect of a brain injury, for example? The whole idea frightens me because I wonder if something else is going to suddenly jump out of the woodwork at me (so to speak).

I am in college and having a really hard time with much of my classwork. Part of that could be due to stress, but now I wonder if any of it is due to subtle brain changes. I was in school before and did pretty well, but now I usually have no idea how I am doing and have a lot of trouble figuring out the kind of things that were simple before.

The first question about how do you know if it's PTSD or brain injury is still one that cannot be answered completely by the medical community. But your second paragraph sheds some light on your particular situation.

Your difficulty figuring things out that were simple before is classic brain injury due to a combination of memory and cognitive issues. It's not that you cannot figure those things out. As you said, you're having difficulty. You may have some cognitive functions (figuring) working with delayed memory response. That slows the process, making what was once simple more difficult.

You might find it quite helpful to keep a planner or journal in which you maintain a number of "lists" that include detailed instructions for doing things. Those things being what you're having trouble figuring out. My wife lost all knowledge of multiplication; so a carry-along calculator became essential.

She would sometimes forget the exact steps to be taken in figuring something out. So we made a list of step-by-step instructions for numerous tasks. When she began a particular task, she would turn to that list. That way, she did not have to use brain power to recall the steps; she could use the brain power to perform the steps.

Hope this helps.

If you are such an expert at figuring out if someone has brain damage due to hit over head, how you explain this.

An individual has three brain injuries requiring 15 stitches each time. Two years apart each acident. Suddenly, he gets the whole body jerks sometimes. Then, at other times he gets un-controlled movements in his legs and arms, arm flelling up in the air. When, he types messages or letters he leaves out letters or whole words never make it from his mind to his figure tips. So, he ends up missing whole words from his sentenses. He must constantly go over his writing everytime he writes anything. Before his acidents he never had any of these things happening to him. But, after the accidents they seem to being getting worse each year that goes by. Then, at other times he has small illusionation lasting only a few seconds to a minute. Wouldn't you call that brain damage of some sort?
Would that be an example of Traumatic-Epilepsy resulting from a TBI?

quote:

An individual has three brain injuries requiring 15 stitches each time. Two years apart each acident. Suddenly, he gets the whole body jerks sometimes. Then, at other times he gets un-controlled movements in his legs and arms, arm flelling up in the air. When, he types messages or letters he leaves out letters or whole words never make it from his mind to his figure tips. So, he ends up missing whole words from his sentenses. He must constantly go over his writing everytime he writes anything. Before his acidents he never had any of these things happening to him. But, after the accidents they seem to being getting worse each year that goes by. Then, at other times he has small illusionation lasting only a few seconds to a minute. Wouldn't you call that brain damage of some sort?
Would that be an example of Traumatic-Epilepsy resulting from a TBI?

The body movements you mention certainly indicate a seizure of some type; epilepsy? I have no clue about that.

The problem with letters and words are classic brain injury symptoms. My wife still substitutes "b" for "p" and vice versa...17 years after her injury. And, yes, she too proofreads and proofreads and proofreads everything she writes. The vast majority of people fail to proofread emails, etc. before sending; but it's pretty important for someone with any type of brain injury to do so. Like you said, enough words missing from a sentence sort of makes that sentence fail to convey meaning, or might even convey the wrong meaning.

A hallucination of few seconds duration "could be" migraine headache. There are many levels of migraine, and that happens with one of them. Whether of not that is "his" problem should best be diagnosed by a physician.

Never mind it made no scense. Keep up the good work.

This message has been edited. Last edited by: 8404_8406_9,

New Study Provokes Concern

"Dr. James Kelly, a neurology professor at the University of Colorado and co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues – dismissing true brain injury features as psychological only. Kahlor states that the military does not want to diagnose people with brain injury, and as such may diagnose individuals as suffering from PTSD (Post traumatic stress disorder), since PTSD and TBI present with similar symptoms.

One may wonder why our military would prefer a PTSD diagnosis. According to Sgt Kahlor, who has been diagnosed with PTSD and experienced concussions while surviving four explosions during his deployment to Iraq resulting in injuries such as a detached retina, seizure activity, and headaches, the military prefers to diagnose soldiers with PTSD because TBI disability compensation is much higher."

To read the entire article on CNN, visit:

http://www.cnn.com/2008/HEALTH/01/30/brain.injury/index.html

Thanks netven, both for the recent post and your starting this topic. I see many PTSD and TBI clients at the Chillicothe VAMC.

To all, here is an important quote from the article, please do not take it out of context, all of us need to read the entire article:
"A new military study published Wednesday in the New England Journal of Medicine says soldiers who suffered concussions in Iraq were not only at higher risk of developing post-traumatic stress disorder and depression, but also that the depression and PTSD, not the head injuries, may be the cause of ongoing physical symptoms.
Five percent of the 2,500 soldiers surveyed by Walter Reed Army Institute of Research said they had concussions in which they lost consciousness during combat. Forty-four percent of these soldiers ended up with PTSD.
Researchers were surprised to find symptoms normally associated with concussions -- headaches, dizziness, irritability and memory problems -- were actually related to PTSD or depression..."

They only relate TBI with combat, seems kind of narrow minded doesn't it?

Dr. James Kelly, a neurology professor at the University of Colorado and a co-author of guidelines the military uses to identify traumatic brain injury, expressed concerns that doctors will attribute lingering health problems to psychological issues.

"I think if people misunderstand or overextend beyond what this survey shows, they could dismiss true brain injury features as psychological only," Kelly said. "It would be a terrible disservice to our military for that to happen."
______________________________________________________________________


I wanted to put the rest of what Dr Kelly said about TBI/PTSD because I think its VERY important to understand. Cause "what he said" is probably what is happening, and what will continue to happen.

And my 2 cents, gleaned from 27 years of using the VA healthcare system asa disabled vet, is that Dr Kelly hit that nail square on the head.

Now; if you've recieved a concussion while ina combat arena, and present yerself to a DOD or VA healthcare facility,they gonna diagnose you with PTSD. IF they diagnose you with anything.

I have peripheral neuropathy, diagnosed by the VA. After the EMG studies were concluded, a VA staff Neurologist at the VAMC facility I go to(VAMC Jamaica Plain Ma) came into the EMG lab to read the test results.

He read my results, looked at me and said "You have diabetes??" (these were the 1st words outa his mouth to me). I don't.

He then carried on "well, you have peripheral neuropathy and the two main causes are diabetes and alcoholism, so ya must be an alcoholic". Which I am, sober now almost 15 years. Which he also coulda found out prior to talking to me by looking at my VA medical record. Maybe setting the scene.

"Oh well", he goes, thats why you have PN", and in four minutes or less I'm not only diagnosed with "PN", but the cause is also ascertained. And into my official VA medical Record(which I have a copy of) goes his statement, which ends with "PN X alcohol abuse".

So, being the non-trusting of anything that the VA says to me type of person, I come home and "google" peripheral neuropathy, and GUESS WHAT, there is a WHOLE HOST of reasons to have "PN", alcohol and diabetes only 2 of 'em. And it ain't the alcohol that gives ya the "PN", I guess its the diet alcoholics have that causes it. As in an all alcohol diet, which leads to vitamin deficiencies. I guess it would be an alcoholic choosing booze over eating. Something I NEVER DID.

But what is another VERY POPULAR cause of "PN" is working in confined quarters in akward positions, actually crushing or pinching nerves, which I did ALOT of both in the military and asa civilian.

I'm just telling ya all this to illustrate how the VA diagnoses and finds cause for conditions.

And Sgt Kahlor says almost the exact same thing in the article-

______________________________________________________________________

"A doctor in Fort Irwin looked at me and glanced at my records for 10 minutes and wrote on my records that he thought my symptoms, my claims were psychosomatic, where I made them up myself," Kahlor said. "He's basically seen me once. He wanted to send me to a med board to get me out of the Army as soon as possible and pawn me off to the VA system."


-JRC

Oh sure, similar experience here, regarding another sort of physical issue. I have a service conencted for a detached retina they managed to reattach while I was AD. I requested a re-assessment awhile ago after a second detachment and surgery. They scheduled me for a Saturday, failed to inform me, and when I found out sheerly by accident while asking th gal at the ifo desk about something else "Why do you have an appointment for this saturday? I didn;t know we had appintments on saturdays..." and went in the doc spent about 10 minutes if that, and said there was nothing wrong with me.

I beleive it's all standard procedure; it happens too often not to be.

An intresting study. Results are conclusive in my opinion. Hope you find this helpful..

Special Report..


Brain-injured war veterans show a faster decline in cognitive functioning as they age

A study of Vietnam war veterans who suffered brain injuries during the conflict has found that the men show a faster decline in their cognitive functioning as they grow older than veterans without such injuries.

Published online today (Wednesday 19 December) in the journal Brain [1], the study has found that the rate of decline can be predicted by how intelligent the veterans were before they were injured, their level of education, the size and location of the injury, and certain genetic markers that have been linked to brain injury and neurodegeneration. Greater intelligence and a higher level of education before the injury was sustained were associated with a lesser decline in cognitive functioning in the years afterwards.

Dr Jordan Grafman, one of the authors of the study, says that governments need to bear these findings in mind, particularly in the light of the head injuries being sustained in the on-going conflicts in Iraq and Afghanistan. “Nearly two-thirds of injured US soldiers sent from Iraq to the US army medical center have been diagnosed with traumatic brain injuries,” he said. “The additional burden of accelerated cognitive decline to brain-injured veterans should be considered when estimating their future healthcare needs. These veterans would benefit from life-long care by neurologists and specialists in head injury. Particularly as they age, given their injury, they may have greater needs than others and the healthcare system, if prepared for this, can essentially shadow these soldiers.

“Clinicians treating veterans with brain injuries should evaluate any changes in their neurobehavioural status carefully so as not to confuse an exacerbated decline in function with dementia.” [2]

Dr Grafman, the senior investigator in the Cognitive Neuroscience Section at the National Institute of Neurological Disorders and Stroke, National Institute of Health, Maryland, USA, and his colleagues studied a group of Vietnam veterans with penetrating head injury (PHI) 36-39 years after the injury. The veterans were part of the Vietnam Head Injury Study, a prospective follow-up study of about 2,000 Vietnam veterans that has been running since 1967. This most recent report is on the third phase of the study, and it looks at a total of 199 veterans who are now in their mid to late 50s.

The researchers used the Armed Forces Qualification Test (AFQT) as the means of measuring intelligence. The men would have taken the test at the time they joined the armed forces, giving a baseline against which subsequent test scores could be measured. It has a range from 0-100.

By the time of the third phase of the study, men with head injuries had a median average AFQT score of 54, while a control group of Vietnam veterans without head injuries had an average score of 74. When the researchers looked at the rate of decline between the second phase of the study (carried out between 1981-1984) and the third phase, they found a faster rate of decline in the brain injured group: the AFQT score declined by an average of seven in the men with head injuries and four in the control group.

However, when the researchers analysed the results more closely they found that a higher AFQT score and a higher level of education before the injury were both significant predictors of a slower decline in post-injury cognitive decline up to phase two of the study, but at phase three, only a higher preinjury AFQT score was protective in terms of later decline.

“Greater levels of preinjury intelligence were associated with lesser decline in long term AFQT scores,” said Dr Grafman. “A higher AFQT score before injury acted in a protective manner and even predicted a higher AFQT score over 30 years after the PHI. Change in AFQT score in the first two decades after the injury was most associated with preinjury intelligence, and to a lesser extent educational duration. Thus, it appears that educational level has an impact earlier in the process of recovery from head injury. However, AFQT score prior to injury remained the greatest forecaster of overall cognitive outcome in the study’s third phase, almost four decades after PHI.”

He believes that greater intelligence is an indicator of the brain’s ability to establish multiple neural connections and that this enables the brain to recover better from injury. “In essence, the more you dive into intellectual pursuits, the richer the intra- and inter-connectivity in a brain region leading to greater protection following brain damage,” he explained.

When the researchers looked at the size and position of the brain injury they found that the size (measured as total volume loss by a CT scan) was associated with a decline in intelligence in the earlier phases of the study, and if the left ventricle and right frontal regions of the brain were injured, this also caused a greater decline in intelligence by phase three of study.

They investigated the links between genetic markers and cognitive decline and found that one marker, a receptor for a glutamate neurotransmitter (called GRIN2A), did predict the change in intelligence over the years. GRIN2A is linked to the age of onset of Huntingdon’s Disease and to the brain’s ability to re-establish neural connections. Dr Grafman said: “This is the first study to examine genetic factors in the long term outcome following PHI and it suggests that genetic markers may play a small but significant role in different stages of cognitive recovery or decline after head injury. This is an interesting but tentative result, which requires further investigation to establish its significance both in terms of degree and timing of its impact following a head injury.”

He said the decline in cognitive functioning seen in the head injured veterans could mean that they might have to take early retirement from employment and might be less able to manage domestic responsibilities. However, the research could be useful for the men, their families and their doctors. “By telling patients and their families that later in life they will be at risk for a more rapid decline in certain abilities compared to unimpaired individuals can be difficult to hear,” he said. “But it can be helpful in terms of long term planning and, potentially, practices could be developed that might protect against it, like staying physically fit and intellectually active.”

At last the issue is getting the studies needed. This is an extremely important issue, both combat induced as well as non-combat.

Bump

A quote from the PICAYUNE ITEM — Published: April 26, 2008 06:48 pm

The problem with TBI is that even with facilities and programs to assist, the victim of TBI may never seek out the help. We as a supportive community must be aware ourselves of the issues that face our young men and women as they return.

Can TBI be fatal? In a way, yes. The suicide rate among active duty soldiers for 2007 reached their highest level since records began. According to the Medical Journal of Australia, people with TBI have an increased risk of suicide, suicide attempts and suicide ideation compared with the general population.

This orginally appeared in an April 26th column of Picayune: Written by free-lance columinst Tracy Williams. I have provided a link to full article, along with quoted paragraph below...


The hidden war: American soldiers vs. TBI
They are the pride of America, returning soldiers from the conflict
around the world. Just the sight of one of these brave heroes in uniform
makes our hearts swell knowing the sacrifices and hardships they have
given for our freedom. But at what price.



To read the rest of the story, go to
http://www.picayuneitem.com/features/local_story_117184852.html

This message has been edited. Last edited by: pipedreamsandbabies,

This resource is a joint-operation run by DoD, and VA...


Hope the information presented helps

http://www.dvbic.org/

I was diagnosed with TBI, and PTSD, and OCD, along with my other injuries. I am 100% Permanent and Total have been for a year. The VA wants to do a MRI in a couple of days, so they can locate a nerve in my head that are causing my headaches and blackouts, they say once they locate it they can kill the nerve and tie it off, does this sound any where near safe or a smart thing to do. What if they cut the wrong one? I know my memory is awful my wife has to write things down for me, little things at that, like eating, taking showers, brushing my teeth, etc... I just can't remember anything. I live by post it notes, I don't know why I was diagnosed with OCD, I guess because I can't remember crap, and I do it a hundred times.

You are asking for medical advise. I would talk to the doctor(s) after the MRI results and discuss this with them. Have your wife or another advocate (or both) with you. It really depends on where the nerve is that is causing the problem.

Dave_M hit the target dead center. Your medical providers are the only ones to deal with these issues. You need to take your support persons with you.

quote:

Originally posted by SSgt65:

quote:

Originally posted by 16903676:
I got a TBI when I was only twenty one years old them a second two years later. Then 4 yrs later I got struck in the head again. Believe me these took place in the 70's and then try having Generalized Anxiety Disorder on top of head injuries. I have never been able to work since that time. Yes, it was and still is frustrating trying to convince the military and the VA of the damage one gets while working on the job and getting injured at the same time. I had to re-write this whole article several times before I can post. Because, I get words and letters backwards and some words or letters are missing from my statement so I must go over and over my post to make sure it makes sense. I was never this way before my many head injuries. One required 15 stitches to sew me back together again. The second one happened when I was 25 miles away from my base and in the middle of nowhere. I had to drive myself to the US Army Hospital across the desert by myself. Half the trip to the hospital I still cannot remember how I got there to this very day. One hand on the top of my head the other sterring the vehicle. After the second hit I was never quiet right, well at least my nervous system started failing me.

I'm with you dude, I have the seizures, cognitive problems, short term ,, and the list goes on

Just hang in there,,, All your Veteran Buddys are here.

The University of Cincinnati was awarded a five-year, $2.3 million grant from the U.S. Department of Defense to study traumatic brain injury and post-traumatic stress disorder.

Researchers from UC's psychiatry and neurosurgery departments will team up with staff at the Cincinnati VA Medical Center, University Hospital and The Neuroscience Institute to form a research consortium on the issues, said Raj Narayan, principal investigator for the project.

The two conditions are considered the signature disorders for troops in the Iraqi and Afghanistan combat theaters.
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The scope of the studies is yet to be determined, Narayan said. UC is one of 10 institutions awarded one of the DOD grants.