
Source: Definition of Mild Traumatic Brain Injury Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine.
J Head Trauma Rehabil 1993:8(3):86-87
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My fortune cookie told me one day: "Your ability to juggle many tasks will take you far." As I thought about being a trial lawyer - the memory, analytical ability and speed of information processing required to try a case in front of a jury - I realized that without the ability to juggle information, I could not do my job.
Then I thought of my professional clients. I thought of those still exceptional people, who were having such a difficult time coping with their jobs. Like a juggler, whose hand speed was suddenly reduced to "average", they no longer could keep enough information balls in the air to distinguish themselves.

The most disabling aspect of the attentional/processing speed problems that come with diffuse axonal injury, is the cycle of overattending/fatigue. This is especially true with those whose jobs require intense concentration or fast paced decision making. The pattern that I see in my practice is highly successful individual before the concussion, who still has exceptional intellectual capacity, but whose ability to marshall that capacity has been slowed. When allowed to work in a quiet place, with only one input at a time, they function for several hours, at the same level they did before the injury.
The problem is that it is very difficult to be a successful executive, without having to deal with more than one input at a time. And even if they are able to insulate their work environment from multiple stimuli, they can only sustain concentrated work effort for a few hours at a time. If as Gronwall and Wrightson suggest, they are able to "rest for an hour or two", in essence take a nap, they may be able to continue on, on the good days. But invariably, there are the bad days, the days when too much done the day before, or too little sleep, or too much other stress, makes it so that they don't start the day renewed. On such days, they might as well stay at home.
There is unquestionably a vocational role for exceptional people with such disability to play in our economy, yet finding an employer who is willing to accommodate a midday nap, a completely quiet work environment, and ONE-TASK-AT-A-TIME is difficult. Try to design a workable job for such person, it can be done. But remember, the employer will not be able to always RELY on person who in their good hours, might otherwise be their most valuable employees. Two things make this task more difficult:
Why subtlebraininjury.com?
subtlebraininjury.com is a website with a mission to educate with respect to the magnitude of brain injury which does not involve coma - injuries that have been labeled by names which grossly minimize their potential impact upon the life of the injured person. This site is brought to you by the advocates of the Brain Injury Law Group, a community of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI.
Additional Information
For a full treatment of the topic of brain injury, and recovering adequate compensation for those who have survived such injury, please visit our other pages. tbilaw.com A general treatment of all types of brain injury, including severe brain injury and concussion, with a special focus on the legal aspects of recovering full and adequate compensation for such injuries. tbilaw.com has been at the cornerstone of the web advocacy of the Brain Injury Law Group since it went online in 1996. waiting.com A page designed to assist those with issues regarding coma, especially in the acute phase when the doctors are saying "I just don't know." vestibulardisorder.com Addressing vertigo and dizziness resulting from trauma as well as information and resources for vestibular disorders.
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