Myth 5: The effects of TBI are immediate.

James Smith was stopped at a red light when his car was struck in the rear. At the scene, he was dazed and told the rescue squad personnel that he had pain in the back of his neck. He was taken to the local emergency room where again he complained of neck pain. He was examined, evaluated and released a couple hours later. Over the next couple of days and weeks, James began to experience problems with his attention and concentration. He began having difficulty at work and his relationship with his family began to suffer. His doctors ultimately diagnosed a mild traumatic brain injury, though doctors retained and hired by the insurance company disagreed –arguing that because James did not complain of TBI symptoms immediately following the crash he could not be suffering from a traumatic brain injury.

Are these defense doctors correct or are they simply perpetuating a myth? In Greenfield’s Neuropathology, the authors write:

“Under conditions of mild to moderate TBI, it is now apparent that there is a process of delayed axonomy in which the actual disruption of some axons does not occur until some time after the original injury. Axonomy only becoming apparent between six and 12 hours after injury. Thereafter, the proximal segment continued to expand.”

This delay in recognizing the symptoms of traumatic brain injury also was discussed in the National Institute of Health’s consensus statement, writing that as individuals with TBI attempt to resume their usual daily activities, the environment places increasing demands on them uncovering additional psychosocial consequences. For example, executive dysfunction may become obvious only in the workplace.

You can read my other posts on the 10 myths of traumatic brain injuries here.