#15: TBI severity needs to be redefined (Dr. Diaz-Arrastia part 1)

Concussion Stories podcast

TBI (traumatic brain injury) severity is currently classified as severe, moderate and mild traumatic brain injury. According to Dr. Ramon Diaz-Arrastia, these severeness levels are misleading. It is true that severe brain injuries are often life-threatening and they are therefore a severe injury. On the other end of the spectrum, mild traumatic brain injuries (concussions) are expected by people to be mild. However, about 50% of people with a mild traumatic brain injury have not fully recovered 6 months after injury. There is nothing mild about a concussion. Dr. Ramon Diaz-Arrastia pleads for changing the way the medical system currently ranks TBI severity. What follows is the transcript of 1 out of 2 Concussion Stories episodes with this outspoken expert involved in leading research on traumatic brain injury.

Interview shownotes: https://www.lifeyana.com/tbi-severity/

Free guide: https://www.lifeyana.com/3-ways-to-speed-up-your-concussion-recovery-right-now/

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Table of contents
[00:45] Dr. Ramon Diaz-Arrastia
[03:41] Post-concussion syndrome is a brain injury
[09:55] “Concussion” is a misleading word
[11:52] The current TBI severity classification is outdated
[15:47] Accurate concussion diagnosis and prognosis
[20:10] Active concussion recovery is essential

Listener Pamela Treischel asked:

Enjoyed this episode and agree that 'concussion' is very confusing word as is the current classification systems! Curious... why does post-traumatic amnesia occur and why does that increase the risk factor?
Our reply:

Hi Pamela, thank you for asking this question! Dr. Diaz-Arrastia wrote the following answer for you:

"This is a great question. Amnesia is different from consciousness. Certainly everyone who is unconscious (due to disruption of the key brain circuits that are required for consciousness) is also amnestic. However, (and TBI is one of the most common examples of this) there are situations where patients are conscious (i.e. they are able to give their names, follow comments, even have some very short-term memory) but are not able to lay down medium and long-term memory. This is due to dysfunction of a set of brain circuits that are required for consolidating memory, which are different from the neural circuits underlying consciousness. It turns out that the duration of post-traumatic amnesia is a more reliable predictor of long-term outcome that duration of unconsciousness.

The other issue is that amnesia is not like in the movies, where someone turns on a switch and memory is completely normal after a certain point. In real life, there is a period of time where some short and medium-term memory is present, but not completely. That is explains why some patients report that they have several years of post-traumatic amnesia, even if during those years they were working, fulfilling their family responsibilities, etc."

We hope this helps!

With love, Melanie