Diagnosis and Prognosis

Why it's important to seek medical help when, say, somebody has fallen over and banged their head, is that the immediate concern might be that there has been some kind of bleed in the brain as a result of trauma. So, the medical staff will be looking at things like the pupil reactions in the eyes, be checking pulse and blood pressure, which will give you an indication as well that there may be an intracranial bleed; so that would be the first screening. People may still get through that okay, but they may develop what we call post-concussive symptoms. So, say like two or three days later, because you cannot necessarily see a mild concussion on the CT scanner or on an MRI scan; it won't show up on that. A few days later, they may start complaining of symptoms of fatigue, not being able to concentrate very well and just generally feeling out of sorts. And at that point, it is worthwhile for them to go back and see the doctor if they haven't seen the doctor before about those symptoms, because it takes some time for maybe the bruising to come out on the brain.

So there is the initial, yes, we need to check out that there isn't a bleed taking place as a result of a head trauma, by the measures that I just mentioned, but also there is the post-concussive a few days later part to it as well. And when people start experiencing that kind of symptoms, they also really need to go back to the doctor, have that checked out. 25% of brain injuries are non-traumatic brain injuries and some of those are going to be stroke related. Some of them are going to be infection related; others will be due with having oxygen deprived to the brain, say through things such as drowning or not being resuscitated quickly enough or heart attack and not being resuscitated quickly enough. So those are quite, kind of, common other causes for brain injury.

Some are more easily diagnosed than others. Somebody has had a heart attack, you can usually see they have had a heart attack and they have stopped breathing and require resuscitation. If it's encephalitis, you are more likely to go to the doctor with various symptoms, and the doctors first thought may not be this person has developed encephalitis in the brain; so you feel unwell. And so, they will need to do lots of checking out and ruling out other causes of you not being well, before they finally arrive at a diagnosis of encephalitis. Tumours in the brain, well, that's more likely that you have gone to the doctor with a range of neurological symptoms that you don't quite understand, and then they will probably send you for a scan to determine what is going on inside of your skull - what's happening to the brain. So that would be the root by which they will understand that kind of damage is taking place.