Articles from prior issues of The Advocate

January/February, 1998

Brain Damage Discussion
by Marta Roberts, Kentucky DDS

DRS. JANE BRAKE AND VIRGINIA Moody conducted informal training on brain damage September 16th and 17th. These training sessions primarily consisted of in-depth information about subtle brain damage, “higher executive functioning.” In particular, the discussion involved multi-infarct strokes, post concussive syndrome, dementia pugilistica, “soccer headers,” loss of brain function secondary to cardiac bypass surgery and anoxia. The discussion also involved the subject of dyslexia. With multi-infarct stroke, one would see a steady decline in function; a cumulative effect. Post concussive syndrome is being looked at more closely now, and has been incorporated in the DSM IV. Dementia pugilistica is associated with boxers. The constant pounding and twisting of the head that take place during matches is the direct cause of this disorder. “Soccer headers” refers to too much force on the head, which can result in concussion. More of this is being seen, especially in children; however, this only occurs when that particular soccer maneuver is not being utilized properly. Regarding cardiac bypass surgery, seven percent of bypass patients suffer loss of brain function, and this has primarily affected white male executives. In addition; the use of heart/lung machines can “wipe out” brain cells, thus, resulting in brain damage. Anoxia is another form of brain damage, and isn’t always severe or obvious. Anoxia doesn’t always show up on EEG. In addition, a series of exercises were administered to the audience to give them the dyslexic person’s perspective in order to enable the audience to understand the difficulties and frustrations that are frequently associated with this disorder. It was pointed out that brain damage may be mistaken for lack of motivation and other behaviors. Also, laboratory studies, a psychiatric exam, or physical exam may even be normal in these kinds of patients. Even if a person has had surgery and the neurosurgeon says that the patient is “doing wonderful” doesn’t mean that the patient really is. The whole sense of self is disorganized. The patient may be “valiant” about covering it up, and may report to his/her doctor or others that he/she is doing fine. A third party perspective is ALWAYS needed. Look at the function, and what may be wrong with that function. For SSA purposes, a detailed family history and neuropsychological exam is important. REMEMBER: think of ALL the senses when there is brain dysfunction. A part of the brain, the size of a match head, has over a billion synaptic connectors; “more stars than there are in the Milky Way.” So, even the slightest bit of brain damage can go a long way.