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Brain injuries are often more complex than the scans show

Traumatic brain injuries are among the most tragic outcomes of serious accidents. A severe injury can leave the victim institutionalized for life. Even milder brain injuries, however, can have far-reaching effects on all areas of life. And science is only beginning to make sense of the most complex organ in the human body.

In a recent Wall Street Journal essay, a neurologist explains how advances in medical technology are both a blessing and a bane when it comes to brain injuries. Imaging technologies such as CT scans allow us to diagnose and treat these injuries with more accuracy (and effectiveness) than ever before. But they don't provide the whole picture, which means they can lead doctors astray.

Why patients' experiences matter

Brain scans and test results can't supplant what has long been the foundation of diagnosis and treatment: the patient's own experience. What kinds of symptoms is she experiencing? Is there a pattern to the pain? How does he describe his limitations?

Painting the whole picture requires taking all these details into account – which means scans must always be interpreted in light of the patient's narrative.

Examples from epilepsy patients

The WSJ essay explores this principle in the context of epilepsy patients, who essentially suffer from a form of brain injury. Many epilepsy sufferers have unique seizure patterns and symptoms that unfold the same way during every episode. By making note of those symptoms, doctors can often tell which parts of the brain are impacted – the language centers, for example, when the patient loses their ability to speak. "Mapping" out the source and path of the seizure in this way provide deeper insights – which can then be confirmed or expanded with imaging scans.

The same principles apply to victims of brain injuries from car crashes or other traumatic events. Only by taking into account the whole picture – including the victim's descriptions of what they're experiencing – can a proper diagnosis, prognosis and treatment plan be developed.

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