RISK FACTORS AND RED FLAGS: IDENTIFYING MILD BRAIN INJURIES

Mild Brain Injury Defined

It is considered a mild brain injury when a patient has any of the following:

• Loss of consciousness
• Any loss of memory for events immediately before or after the trauma
• Any alteration in mental state at the time of the trauma including feeling dazed, disoriented or confused
• Focal neuro deficits that may or may not be transient but where the severity of the injury involves a loss of consciousness of 30 minutes or less, a Glasgow Coma Scale score of 1315 (when loss of consciousness is more than 30 minutes), and post-traumatic amnesia less than 24 hours.

While typically the trauma causing the injury occurs when the head comes up against another object, as in a motor vehicle accident, a fall, or a blow to the head, mild brain injuries also occur from blast injuries and shaken infant/child syndrome.

Risk Factors

• Substance use or abuse. Indicated in more than 50 percent of brain injuries including TBIs.
• Gender. Males are twice as likely as females to sustain a brain injury (slightly less for military).
• Profession. Risky professions include truck driver, construction worker, police officer and convenience store clerk.
• Military service. Military personnel are at higher risk than civilians.

Signs and Symptoms

Because people quickly learn to compensate for their deficits—whether consciously or not—with each group of symptoms we also have listed the red flags. These are the indicators that a person may be masking an injury or be unaware that they have diminished capacity to perform tasks they once easily accomplished.

Cognitive symptoms may include issues with attention difficulties, concentration, memory and orientation.

Red flags include:

• Avoiding reading
• Inability to find car in parking lot
• Getting lost while driving
• Missing appointments
• Stops watching TV or movies or playing video games
• Physical symptoms may encompass headaches, dizziness, insomnia, fatigue, unsteady gait, nausea, blurred vision and seizures.
• Irritability
• Sleeping during the day
• Low tolerance for noise
• Poor appetite
• Avoiding driving
• Avoiding activities that require walking
• Behavioral symptoms may cover irritability, depression, anxiety, sleep disturbances, emotional outbursts, loss of initiative, and problems at work and school.
• Low tolerance for lots of activity in their environment
• Spending excessive time alone
• Worrying about upcoming events
• Avoiding large gatherings
• Crying more easily
• Arguing more frequently
• Showing a lack of respect for others

Listen to the Family

Often it is the family who finally reaches out to a medical professional for help for their loved one. They may not be able to pinpoint exactly what is wrong, but they will be very clear that he or she “is just not the same” since the trauma. Listen to them. They can be the best red flag of all.