A Dent Doesn’t Appear Over Time…How Come Brain Injury Symptoms Can Show Up Later?

We had a case recently with a defense engineer/doctor who trumpeted: “Trauma is an event not a disease.” He compared the body of a human to the body of a motor vehicle.

But tissue is not inert like sheet metal. Trauma does not simply “end” at the moment of impact; trauma initiates a process.

A better analogy—but maybe one that didn’t line up with his motivated reasoning—is comparing a brain that’s been injured to an electronic device that’s been dropped on the ground.

The electronic device may seem to function like it did before it was dropped. And the case may appear normal. But on the inside it’s sustained microscopic structural damage, impaired connections, stress concentrations and/or latent instability. These problems get progressively worse under repeated load, heat, vibration or ordinary use.

The same thing happens in the brain after something like a rear-end collision. Acceleration causes microscopic axonal injury, metabolic disruption, neuroinflammation, impaired connectivity or vascular dysfunction.

Initially the brain and other related symptoms can compensate for the damage. But the brain contains living adaptive networks under constant metabolic demand. That means a subtle injury that goes unnoticed to start with can come into view over time when demands increase and the brain can’t continue to co compensate for the injury. This happens a lot when demands increase (like when someone goes back to work after a week or two of brain rest).

Damage to the brain takes place at the time of injury. Or as responses to the injury like inflammation progress. But symptoms might not show up right away. Just like when a phone is dropped, looks fine, but then shows degraded performance when put back to work.

The body is not made of sheet metal. Brain injuries happen in an instant. But deficits may take a while to appear just like when you drop your phone.

#mtbi

#concussion

#brain

#symptoms

#delay