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Little Known Symptoms / Injuries from Traumatic Brain Injury

Along with the standard injuries involving cognitive ability, personality change, executive function decline, and others which have been widely reported on, there are additional injuries and symptoms suffered by those who have had traumatic brain injury, which are not widely known but can cause profound problems. These include:


Vision disturbances following traumatic brain injury are common, seen in 30% to 85% of cases. These symptoms are often one of the last to be treated and often escapes detection. Standard treatment by an eye doctor or ophthalmologist can often fail to find the cause of blurred vision, photo sensitivity, change in field of vision and anomalies of accommodation commonly found after TBI. The most common, difficulties of "accommodation," may result in blurred vision. This is the eyes inability to accurately change focus from far to near or from near to far. Difficulties of "version" are seen in such abnormalities as saccads, pursuit and fixation, and other changes which result in lost of place while reading, skipping lines, or re-reading lines due to abnormal movements of the eye. Thirdly, there are abnormalities of "vergence" which result in occasional or constant eye strain or sense that the print on a book is "shimmering" or "floating" on the page. There can also be abnormalities of the field of vision can result in lack of awareness of the field of vision on one side or the other side of the body. Finally, there can be abnormalities in light sensitivity which can cause pain and headache in patients.


Sudden sensorineural hearing loss (SNHL) is a common phenomena which can be caused by trauma, infectious disease, or tumor. It is often found in conjunction with damage to the vestibular system of the body, which deals with balance. A common test done by physicians called Romberg Test provides information on the integrity of the system. Audiologist can do hearing tests which can confirm or point to this diagnosis. Many patients recovery full or partial hearing loss after a year or two.


Cranial nerve damage is a common finding in mild to moderate head injury. One of the results can be a loss or alteration in the sense of smell and because of that the sense of taste. The loss of smell is called anosmia. Many neurologist and other physicians now have the ability to test for loss of smell. This loss can occur on each or both sides, so do not forget to have each nostril tested separately. In a recent study by Varney and others a PET scan was able to detect the specific brain damage associated with anosmia. If there is an alteration in the way food taste or commonly an inability to cook properly because of lack of smell, please have this testing done.


Especially in cases of moderate and severe brain injury, patients should be routinely given blood tests to see if the human hormonal glands are functioning normally. The pituitary gland is particularly at risk, and blood work should be done to show whether or not the gland is functioning properly. If there is a decrease in the production of growth hormone, rather expensive hormone therapy may need to be implemented because of the long term ill effects of low pituitary output which may affect the heart, the psychiatric status of the patient, and may have other effects not fully know at this time. Many physicians feel that there needs to be observable damage to the small but powerful glands in the brain in order to consider testing for output. There does not have to be observable damage for such an injury to occur, if there otherwise was a moderate to severe brain injury involved in the patient. These glandular disruptions would be the cause of the very common sexual dysfunction seen in TBI survivors.

Another result of glandular dysfunction following TBI is the onset of cranial diabetes insipidus. Therefore, it is important to be on the lookout for signs of diabetes (unusual thirst, change in urination, lightheadedness or fainting) following TBI.