Warning Signs Head Injury

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Warning Signs Head Injury

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Warning Signs Head Injury

What did Henry the Eighth and Howard Hughes have in common?

Both Henry the Eighth and Howard Hughes were rich and famous men. Both were brilliant and dynamic while young, but later they became deeply disturbed individuals. Both men suffered recurrent episodes of significant head injury as young adults. Henry the Eighth was a powerful young man, and like most strong, young men in his era, he was passionate about jousting. He had multiple head injuries sustained during jousting matches, the first occurred in March 1524. Over time he changed into a cruel tyrant with cognitive impairment and impulsivity.  Howard Hughes was multi-talented and had many interests including a passion for aviation. He was involved in four airplane crashes and suffered several head injuries as a result. His behavior also became erratic and unpredictable later in life.

Warning Signs Head Injury

We have all become aware of the hazards of recurrent head concussion in sports such as football and boxing. For anyone who survives acute head injury, there is a risk of cognitive and psychological problems later.  Medical calculators and analytics can assist in assessing risk for consequences from head injury. A sampling of analytics on these topics are listed below.

Consequence of Head Injury

Head injury can cause a broad range of neurologic injury depending on its severity and distribution. Damage may be diffuse or localized, mild or severe. Recurrent head injury can result in cumulative damage.

Diffuse brain damage can result in cognitive impairment and dementia. Localized trauma can result in specific syndromes depending on which specific part of the brain is affected.

Some syndromes of localized brain injury include Russell Syndrome, paramedian diencephalic syndrome, frontal convexity syndrome, medial frontal syndrome and Kluver-Bucy Syndrome. Damage to the frontal or temporal lobes could explain some of the findings seen in these two men. Possible diagnoses to consider are the orbitofrontal and ventromedial prefrontal cortex syndromes. Without a brain scan or brain exam it is difficult to determine which precise areas were damaged.

There are other reasons for rich and powerful people to undergo a personality change, Court intrigue, post-traumatic stress disorder, substance abuse, syphilis, and the corruption of absolute power may have had roles to play. Unfortunately, our social systems allow such behavior to continue with little interference.

Take Home Message

Head injuries can have both short and long-term sequelae. Predicting, diagnosing and managing the wide range of possible conditions is a challenge even for experts. Medical algorithms can help the rest of us deal with these patients better.

 


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By | 2018-04-19T07:07:32+00:00 April 18th, 2018|Clinical Practice, Patient Care|0 Comments

About the Author:

John Svirbely, MD is a founder and Chief Medical Officer of The Medical Algorithms Company and the primary author of its medical algorithms. John is a co-founder of the Medical Algorithms Project and has developed its medical content for nearly 20 years. He has a BA degree from the Johns Hopkins University and his MD from the University of Maryland. He is a board-certified pathologist with a fellowship in medical microbiology and biomedical computing at Ohio State University. Dr. Svirbely recently retired from private practice and resides near Austin, TX. He has authored multiple books and articles on medical algorithms & medical calculators.