A good friend and I were musing one night about his time overseas in Afghanistan, and he shared with me (more or less) the field assessment of attempting to determine if someone had sustained a brain injury. It went something like this: Is there an open head wound? Is blood coming out of the eyes? Is a clear fluid leaking from the ears? is there excessive vomitus?

We were on topic, because he had posted a picture on a social media platform of his five year old son who had sustained an injury from falling… with a goose egg on his forehead overshadowing his brow. My friend had shared the story of the trip to the hospital that followed, and his gratitude that things seemed to be going fine; that is, until I questioned him. His son, in fact, he become wildly needy and very emotional since.

But, back to the field assessment: “T’was a flesh wound” and that whole bit from Monty Python was floating through my mind, as it seemed almost comical, although in reality tragic. If your brain is leaking out of your head, it may very well be that you have a brain injury. You don’t say?

Which brings us to the point: what about anything short of that?

The standard for Emergency Room care across the country in detecting brain trauma is typically CT or MRI, when warranted. Both will pick up a vascular bleed, for sure, but outside of that would be wildly unreliable in determining what long term damage is likely to be present, and most importantly, there is very little follow up to find out. Even with a life altering and life changing injury, it is highly likely, you will be in…and out, in a flash. I hear such stories almost on a daily basis.

Sometimes to get the right answers, you have to ask the right questions, and discard old ideas for new. In upcoming blogs I’ll share about the instruments and imagery I have found to be extremely helpful, and the types of things to look for.