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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It has been hypothesized, that the only neurological deficit post concussion, is with respect to attention and concentration. (Alexander, Neurology, 1995). While we would not go that far, we believe that attention and concentration problems are the most significant cognitive deficit with respect to subtle brain injury. The problem with the "it is all attentional" theory, is that attention and concentration deficits are not the core problem, but a symptom of the seminal problem, which is compromised mental efficiency.
The primary pathology resulting from a concussion is a disruption in neural connections. While these neural connections may regenerate, and in younger people, often so well that apparent full recovery can be achieved, these reconnections are less efficient. The net result of these less efficient reconnections, is that the speed at which the brain can process information is reduced.
Multi-process equals multi-attend. In computers we use the term multi-task. In the human mind, we talk in terms of multi-attend. Perhaps the best way to appreciate multi-attending problems, is to compare the computer you are using today to the one you might have been using a couple of years ago. While the best of the current computers are so fast that we may not notice when we ask our computers to do multiple tasks, the previous generation couldn't do anything else while it was printing.
In the human mind, we encounter these problems when we try to divide our mental processing capacity between two tasks. Most multi-attending is done without thinking about it. We can walk and chew gum at the same time. We can walk and talk at the same time. But the more difficult the mental task, the more difficult it becomes for our brains to jump back and forth between the two tasks requiring some portion of its attention. The less efficient neural reconnections in the injured brain have much greater difficulty multi-tasking.
Most people with subtle brain injuries show little deficit in a routine conversation on the telephone . This is a classic case of single attention. The conversation requires only one sensory input - hearing - and there is little need to divide attention, as only one other person is involved. However, as soon as you add additional stimuli into the mix, multi-attentional problems will start to show up. A child crying in the background, or asking for lunch, will greatly increase the attentional requirements. If the conversation is in person, rather than on the phone, additional distractions become a problem. Now sensory input from the eyes, background noises and personal body language may start to require the brain's attention. What were previously instinctually sensed, may require conscious thought to process.
When the brain is required to concentrate on background processing tasks, problems begin to arise. The solution to this information processing log jam is increased concentration, through a process called overattending. Overattending can work, but it comes at an awful price: rapid fatigue.
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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