What’s the Difference Between a Mild Concussion and a Moderate or Severe Concussion? Post 7

A Traumatic brain injury or concussion is normally graded on a severity continuum ranging from mild, moderate, or severe. Mild concussion or traumatic brain injury (mTBI) can lead to long-term cognitive and emotional difficulties and behavioral disturbances. Because injuries at the more severe end of this continuum are associated with significant morbidity and mortality, there is a lot more attention given to the research of moderate and severe TBI’s.

It is estimated that there are 1.5 million civilian traumatic brain injuries annually in the United States. Furthermore, it is estimated that more than 300,000 US veterans of the wars in Iraq and Afghanistan have sustained mTBI from improvised explosive device blast waves (20% of 1.6 million). Therefore, mTBI is a major public health problem. The results of surveys indicate that mild TBI (mTBI) accounts for nearly 75% of all treated cases. Many milder injuries undoubtedly go unreported.

The diagnosis and treatment of mild TBI have historically been hampered by a lack of evidence-based correlates of these clinical manifestations. Unlike moderate and severe TBI, mild TBI does not show significant tissue lesions or cavities (spaces) in the cortex. Neuroimaging by magnetic resonance imaging or computed tomography is negative in most cases. This means that the damage is beyond the resolution of current structure-based scanning technologies. That is why mTBI has been called an “invisible wound.”

Owing in part to poor understanding of the neuropathology leading to neurologic dysfunction after mTBI, there are no effective treatments. In particular, the absence of gross alterations or findings makes the diagnosis, evaluation, therapy and outcome prediction after mTBI difficult.

However, current research shows that mild TBI leads to extensive dendrite degeneration and synapse reduction in the cortex. This sheds light on the neuro-pathologic consequences of mTBI in humans and suggests that neurodegeneration may be a novel target for developing diagnostic methods and therapeutic approaches for mTBI. This is why it is useful to treat mild concussions much in the same way as you would dementia or Alzheimer’s. Also why it is so important that you rest after any type of concussion as I wrote about in post number 4.