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Hi, I Suffered A Mild TBI (multiple Concussions To The
Question: Hi, I suffered a mild TBI (multiple concussions to the right temporal lobe/right occipital frontal cortex) from an assault. Fractured my right orbital which entrapped my eye. Orbital fracture was surgically repaired with implanted ceramic surgical mesh. I did not do any recommended follow up care, just went home with pain killers and a broken heart (figuratively speaking and from the surrounding circumstances). Shortly after and ever since I noticed a huge change. Suddenly I was agitated all the time, depressed, anxious, paranoid, persecutorily delusional, trouble with short term memory, trouble with audible word comprehension, lack of eye contact, standoffishness, aggressivity, difficulty making decisions, difficulty with time management, knowing a situation was awkward but knowing exactly why, and chronic migraines. I had a five day EEG which detected sharp transient waves in the right temporal region. What kind of testing can be done to determine what whether or not these symptoms are characteristics of an organic mood disorder present BEFORE the TBI, or simply psych symptoms secondary to post concussion syndrome? Thank you so much and if you would like to take this case please contact me.
Brief Answer:
History is the most important.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. There is no investigation/tests to determine whether your symptoms are related to traumatic brain injury (TBI) or they were present before the injury. This can be decided only by history. If the symptoms were present prior to TBI, then, the symptoms are due to a psychiatric illness, unrelated to TBI. However, on the other hand, if symptoms came on only after the TBI, then, we can attribute them to TBI.
Brain functions can be assessed by PET (positron emission tomography) and neuro-psychological testing. These can help us correlate your symptoms to damage/involvement of specific areas of brain. However, causality can not be proved by these tests.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
History is the most important.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.
I have noted your clinical details. There is no investigation/tests to determine whether your symptoms are related to traumatic brain injury (TBI) or they were present before the injury. This can be decided only by history. If the symptoms were present prior to TBI, then, the symptoms are due to a psychiatric illness, unrelated to TBI. However, on the other hand, if symptoms came on only after the TBI, then, we can attribute them to TBI.
Brain functions can be assessed by PET (positron emission tomography) and neuro-psychological testing. These can help us correlate your symptoms to damage/involvement of specific areas of brain. However, causality can not be proved by these tests.
I sincerely hope my reply has helped you.
I would be pleased to answer, if you have any follow up queries or if you require any further information.
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you for your assistance. I understand the significance of the difference between causation and correlation. I will keep this in mind when investigating this issue. What kind of specialist would I need to see to get a PET scan or fMRI in regards to this? A neuropsychiatrist? A nuerologist? A psychiatrist? Thank you. Also I am assuming that due to functional/structural plasticity my brain has compensated for any damage by now. However, such compensation would be visible on the aforementioned scans correct? At least hopefully right? Thanks again.
Brief Answer:
You would need to see a Neurologist.
Detailed Answer:
Thank you for getting back.
You would need to see a Neurologist for detailed evaluation. He may order for PET scan, functional MRI and neuropsychological testing.
These tests would show your current level of brain functioning (or dysfunction). Only, if we do serial testing (say at intervals of 3-6 months), can we find out about improvement due to neuronal plasticity. Generally, neuropsychological testing is repeated. PET is not repeated due to the risk of radiation exposure, unless absolutely necessary.
Best wishes,
Dr Sudhir Kumar MD DM
You would need to see a Neurologist.
Detailed Answer:
Thank you for getting back.
You would need to see a Neurologist for detailed evaluation. He may order for PET scan, functional MRI and neuropsychological testing.
These tests would show your current level of brain functioning (or dysfunction). Only, if we do serial testing (say at intervals of 3-6 months), can we find out about improvement due to neuronal plasticity. Generally, neuropsychological testing is repeated. PET is not repeated due to the risk of radiation exposure, unless absolutely necessary.
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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