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Traumatic Brain Injury - The Invisible Injury Becoming Visible

Karns & Kerrison

Traumatic brain injury has often times been called the "invisible" injury because at times victims of traumatic brain injury do not, on the outside, appear any different than average people and because often times the imaging on the brain of the victim in terms of x-rays, CT scans or MRIs are negative.

Advances in medicine and events bringing traumatic brain injury to the forefront of our society are making this invisible injury become quite visible.

There have been advances in medicine in studying traumatic brain injuries including new programs utilizing the MRI in studying the brain including Diffuse Tensor Imaging (DTI). The DTI allows the mapping of the diffusion process of molecules, mainly water, which reflects interactions with fibers, membranes, etc. Water molecule diffusion patterns can therefore reveal microscopic details. This technique has been successful in showing microscopic injuries causing the traumatic brain injury including traumatic axonal shearing. The neuron is the main cell of the cell body inside the brain connected by long nerve fibers or axons. Axonal shearing can occur in trauma causing traumatic brain injury when the axons are damaged (traumatic axonal shearing) causing a breakdown in the brain cells.

This microscopic type of injury that would, in the past, have been invisible is now being made visible by the use of the DTI. The functional MRI (fMRI) is an imaging technique using the MRI that measures brain activity by detecting associated changes in blood flow. The fMRI has been used by correlating findings of the fMRI in victims with traumatic brain injury and correlating it with their symptoms and comparing these results to average people not suffering from traumatic brain injuries. These comparisons showed reduced connectivity in regions of the brains of victims suffering traumatic brain injuries. Again, this is another method utilizing medical advances to make the invisible injury visible.

In addition, current events causing public awareness are making this invisible injury quite visible. According to the Center's for Disease Control (CDC) "traumatic brain injury (TBI) is a serious public health problem in the United States. Each year, traumatic brain injuries contribute to a substantial number of deaths in cases of permanent disability. Every year, at least 1.7 million TBIs occur either as an isolated injury or along with other injuries."

Traumatic brain injuries are being recognized more and more as wounded veterans come home from the Middle East wars suffering traumatic brain injuries from explosions. In addition, in the sports world, not only in high school and college but also regarding professional athletes, concussions and traumatic brain injuries a readily being recognized and treated.

It is this public awareness that it also helping make the invisible injury visible.

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