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My Traumatic Brain Injury Experience

Posted by encouraged , in Different Place & Time--M... 01 February 2012 · 876 views

The car accident I was in at age 17 did two things. First, it triggered the narcolepsy on. Second, it brought about a mixed set--genetic and injury--of narcoleptic causes. The later seems to come from the flexing of the brain stem and/or squeeze from surrounding brain swell.

I have included a "PhotoShop"ped picture of me with the scar. All the photographers in my school pictures would remove the scar.

Removed from my book said:

The X-rays showed I had a reverberating (reverb) fracture at the base of the skull. The base of the skull includes all the bones between the auditory canal and the forehead, including the thin temporal bone that is so thin and fragile.

A reverb fracture occurs when the skull is compressed then suddenly released. The point of fracture then includes the side of the skull opposite the point the pressure was applied. In my case the point of pressure was also the impact point from my head contacting the ground, and the car slamming the back of my head and then bouncing back up. The point of impact of the ground also brought about a fracture in the front at that site. The two ends of the fractures joined one another.

The impact caused a really bad head wound, too. It was located above the left eye, on the forehead, ripping open the flesh and muscle to the skull. The doctor later told me that he had seen that part of my skull when cleaning the wound.

I was fortunate in that my skull was extensively fractured. The point of impact was left-of-center on the forehead well above my eyebrow–—where I sported a spiderweb scar most of my life. (see picture) The crack to the left of the impact went further to the left and down. It went across the left orbital ridge.

Attachment John 1967 scar cleaned up.jpg

Twenty years later, a Waters sinus X-ray, with newer, more sophisticated and sensitive equipment, revealed that the fracture continued further down into my left orbit (eye socket). This explained the "ere for to" unexplained problems my Uncle Louis, an optometrist, said I had with my astigmatism radically changing in my left eye. Astigmatism is something you are born with--the shape of your eye--and usually never changes.

The crack also went to the right, from the point of impact completely across the forehead, traversed the skull’s right base (probably the temporal bone; the area we usually call the temple), to the right auditory canal. The overall result being that my skull was split like a clam shell. Clam shells can easily hing.
    Thus, with the
  • left side of my skull able to flex in such a manner
  • elasticity of the skull's covering (muscle and skin)
  • facial skin stretched out by the fluids rushing to the black eyes
    the typically fatal hydraulic pressure within the confined space of my skull must have been lowered sufficiently so as to save my life.
My skull was provided with something like a relief valve.

Inside my skull my brain wasn't fairing very well. It was coping with yet another pressure brought about from the tissue swell of a double, front and back, severe concussion. (see other photo) Typically so severe a concussion causes tissue swell that blocks the return of fluids to the rest of the body for processing. Such causes fluid to come into the skull but not leave. That causes a build up a pressure of the amount that the circulatory system can deliver, which is related to the person's blood pressure. This is a kind of hydraulic pressure, since water does not compress.

Attachment 2000px-Contrecoup_svg-small.jpg

A small amount of hydraulic pressure can lift cars. Imagine what it can do to soft brain tissue.

Also, since the skull is pretty much already full to capacity, the injured tissue swell means something has to move aside. So the non-swollen areas of the brain are pushed aside to make room for the swell. But since there is no room for the pushed aside tissue to go, it ends up being compressed.

In the very middle of the brain from front to back is a channel that is like two plates of glass in my insulated windows at home. They are close, parallel, and thereby, do not touch each other. This is called the midline. Due to the swell and compression of tissue, the space between left and right brains remains, but the shape of it changes radically. Now it is more like stacking two cereal or salad bowls together. In such a situation, if the bowls had no flat area on the bottom, they would only touch at the edges, the top rim of the bottom bowl. A midline that has this kind of shape is said to have a midline shift.

I have worked in special procedure x-ray rooms for most of my eight years of that kind of career. I have therefore seen many a midline shift. (see random patient photo) Mine is the greatest shift I have ever seen. Thank God for a clam shell fracture that allowed me to remain alive.

Attachment Epidural_hematoma_arrow.png

Additionally there is compression and a misshapen cerebellum. Thus, I present with truncal ataxia. I have to be careful turning around or looking straight up, as I might fall. It also controls your gate. If I am in a narrow hallway, I might bounce from side to side as I walk down it, like some kind of pinball. And as for walking a balance beam, forget it. I also can't pass a sobriety test, and I have been tested because of my gate and quickly turning a corner and falling. LOL

Imagine all of the medical conditions that were discovered one by one and never associated with traumatic brain injury until just recently.

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I am astounded and amazed at your being alive first. To move on with your life in such a way as you evidently have and to the extent you have is even more amazing. You are quite a human being. God Bless you and keep up the fantastic work.
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Feb 01 2012 11:56 PM
I sincerely agree with Robbie333's comment. I've always enjoyed your thoughtful comments here, and it's a privilege to have you as a friend here at UM.
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Is that actually your CT?  The midline looks not so much shifted as obliterated.  Amazing story of recovery.  Truly inspiring.
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Thank you!

It was just for a lay person to be able to note the areas of problem. Mine wasn't that severe. Mine was more like this one. [Where did the full editor go?] I will add it on the row with the others. Well, can't find it. It looks like a bow and arrow bow, as in bow and arrow. Both ends of the bow, the tips, were in the proper pleace, while the apex was indeed deep. Also, slice upon slice, it had the cerial bowl in a cerial bowl curvature. Lots of swelling.

my coworkers ran it on me to see if we could determine why I was having so much trouble with dizziness.
But then I gave the only copy I had away to a doctor before going to Australia.

I never have seen my cerebellum. It must be interesting since I have truncal taxemia. Nor have I seen my my C2 to see if I might have problems later in life. LOL I am 63.
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