Introduction: Obvious and more subtle brain injury symptoms

So what áre brain injury symptoms? I will try to be as plain as possible and will give many examples of brain dysfunction that can be seen in normal daily life.

First of all, let me be clear about severe and moderate brain injury symptoms. Although relatively easy to detect due to usually very obvious changes in behavior, I will not focus here much on this kind of acute severe brain injuries. The reason is simple: such kind of damage is very easily detected by almost anyone and you gain very little insight when telling about these obvious signs.

No, I want you to know about the more subtle forms of brain injury symptoms because that is where we can benefit the most after reading this site. Usually, mild brain injury or subtle brain damage goes largely undetected but it cán cause deficits in daily life that eventually can lead to serious damage in social functioning, work and activities in daily life. 

Acute and obvious brain injury symptoms

What are then the signs of severe acute brain injury? Well, usually they can be physical in nature like when someone suddenly cannot move his left arm, hand or leg anymore. Walking can become virtually impossible and normally a fall is the result. Or it becomes uncoordinated, without much force, or slow with an unsteady balance. Speech can become slurry, unarticulated, incomprehensible, slow, sometimes due to problems in mouth and vocal chords motor functions (e.g. verbal apraxia), sometimes due to a language disorder (e.g. aphasia). One side of the face can drop suddenly due to a paralysis of facial muscles, usually good to see around the mouth.

Sometimes very little physical signs can be seen but mental signs are all the more obvious: usually a sudden change in consciousness, as if someone is sleepy, drunk, day dreaming or drugged, is found. Just remember what happens in cartoons when someone gets a blow to his head or runs into a wall (traumatic brain injury). But also, in less common cases, a heightened awareness can be seen as when someone is seeing things which are not really there (hallucinations) or thinks in a very unrealistic manner due to a psychosis (as when he thinks he can fly out of a hotel window).

Usually such obvious brain injury symptoms happen suddenly, immediately after some form of severe brain injury like a stroke (infarction or bleeding in the brain) or a traumatic brain injury (e.g. after a serious fall from a building or after a high speed car accident).Less common causes are infections in the brain, drug or alcohol overdose (intoxication), or an epileptic seizure (short circuiting in the brain). 

More subtle brain injury symptoms

As I told you earlier in the introduction my aim is to make you aware of subtle forms of brain injury symptoms so to prevent them as much as possible. In that way, your personal development can become optimal and your ride will be less bumpy and you can save your energy for better things.

As you probably already know, the brain is responsible for all your attention and concentration, your memory, your way of problem solving and your way of seeing, hearing, feeling things. In essence, your brain makes you tick like you tick right now! So when you are reading these words it is your brain that makes you understand what I am saying here. It controls how quickly you get my message, how smoothly you read this page and how much you will remember of this information. So it seems a good idea to keep your brain in an optimal condition.

Then whát is subtle brain injury exactly and whén does science say it ís braininjury ?In fact you have two definitions of brain injury: one is based on the idea of tissue damage or disturbed chemical processes in the brain, the other is more indirect and based on mental dysfunctioning. The first criterium of brain damage requires some sort of 'hard' proof that there is something different than normal. Normal here means 'what is known to be common, the mean, medium in other human beings'. For example, when the hippocampus (a structure in the midbrain, important for memory processes) is much smaller than what is expected in a 40-year old caucasian male, the conclusion might be there is something wrong in his brain. The main problem with this criterium is that we need a large database of data in which we can see whát exactly is normal in a very large group of 'normal' human beings. Such a database does exist but it is nót extremely large and even worse, the variations in brain tissue in normal healthy people are quite large. There seems to be more variation between a lot of brains than between, let's say, human hearts or livers. That makes it quite difficult to make sure whether there is any kind of brain injury or not. The hippocampus of the 40-year old male could always have been that small...we simply can not know for sure...so talking of brain damage is in such a case quite uncertain. 

Neuropsychology: the study of brain injury symptoms

Now, there is a field in psychology called neuropsychology which offers the second criterium of brain injury: a definition based on the mental processing capacity of the brain, more scientifically called: information processing. The brain processes information from its surroundings via our senses like touch, vision and hearing. It interprets this information and we act upon it in a certain way (our behavior). Now this kind of behavior we can study and test. We can compare it to the behavior of many other comparable human beings in comparable circumstances. When we have a large database of behavior to specific tests in specific circumstances, thén we just might say whether that behavior is 'normal' or differs more or less from the mean behavior of many people.

Such a comparison is no less objective or subjective than comparing tissue between many people. However, comparing tissue or blood values is seen as much more 'hard' science than psychology. Understandable perhaps because people do nót know what and how psychology really measures things. More specifically, I want to focus on the field of neuropsychology and explain to you how it cán and does measure brain injury symptoms and how it can determine whether there is something wrong in your brain or not! See the links in my website to different brain functions like attention or memory which not only explain something about what attention or memory is, but also different methods (e.g. tests) are being discussed so you can get a feeling or sense of hów your brain is studied and whether it ís functioning normal or not.

The subtle brain injury symptoms can indeed be found in the functioning of your attention, memory and problem solving. For example, you all know the beautiful game 'memory' in which you have to turn 2 picture cards laid out on a table and you have to win as many pairs of 2 similar cards as possible. Normally, when you are at an age of 7 to 16 years, you are quite good in this memory game. However, when you are getting older (say around 36), you will notice that you can nót win anymore from your own daughter of 7 or 8! No matter what you do! My two daughters of 7 and 12 are beating me all the time with this game. Luckily, I am still the champion on the Nintendo Mario Kart game! 

Tests can determine what is normal when you have brain injury symptoms

So, could I say my brain is damaged? Or is this normal? Well, science can not find anything wrong with my brain by using neuro-imaging (making pictures of my brain with a MRI- or CT-scanner) nor are there any signs that something is wrong with my chemicals (e.g. neurotransmitters) in my brain. However, to be sure, this should be tested extensively but the variations between individuals in the amount of neurotransmitters is very large and no one could tell me for sure whether any value would signify normal or abnormal levels. So, the only way a neuropsychologist would be certain there is something the matter with my brain, more specifically, with my memory, would be to test me with a so-called memory test. Much more about such a test can be found in the 'tests' link on the left of this page.

Suffice it to say here that such a memory test could indeed say at least something with some reliability about my memory functioning. For example, one simple memory test would be to try to remember 3 words like apple, car and sun. After 10 minutes doing some other mental things like for example calculations, I can be asked if I remember those 3 words in the order they were mentioned. Now, when I would remember only 2 of them, or even worse, just 1, thén there would be serious doubt about my memory functioning! This conclusion would be quite strong because we actually have a large database in (neuro)psychology that tells us that only 5% of less of normal people do forget 1 or 2 words in this test. Given that a borderline of 5% or less is scientifically considered as 'not a coincidence' or 'chance', we would certainly say there is something wrong with my memory and further study would be advisable.

To summarize, neuropsychology cán determine with often very simple procedures which we call tests, hów different your functioning in memory or attention is from that of other 'normal' people. This is essentially the basis of all neuropsychological testing: comparing the scores of people on simple tests to the large database of scores of (presumably) healthy people. When and only when there are clear differences between your score and the expected mean score of normal healthy people, a neuropsychologist cán conclude that you have brain injury symptoms that are serious enough to warrant further investigation. On this website I will explain extensively how this is measured and what can and can not be concluded with very different tests. Join me in the detective work of what we call neuropsychology: the study of brain and behavior... 


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