This is a description for brain injuries at the most subtle end of the spectrum. Often the person will appear completely uninjured, only close friends and family will notice the cognitive and behavioural symptoms. Often the injured person is able to continue to work full time for months or even years before finally collapsing from cumulative fatigue.
There is no scan that is capable of detecting this subtle damage because it is usually too microscopic to be seen. Neuropsychological testing can be normal because the tests are poor at detecting damage to executive function which is often the area of the brain most greatly affected.
It is perhaps of no surprise that these cases are so aggressively defended by insurers. In our experience their experts often perform substandard clinical examinations that enable them to conclude that there is nothing or very little wrong with the patient. We are very familiar with this approach and skilled in undermining substandard methodology where it is used.
| Cognitive Symptoms | Emotional and Behavioural Symptoms | Physical Symptoms |
| Short term memory | Disinhibited temper | Dizziness / sickness |
| Concentration | Impulsive spending patterns | Persistent headaches |
| Difficulty learning new information | Disinhibited behaviour | Persistent cumulative fatigue |
| Word finding / fluency | Lack of insight | Visual disturbance including light sensitivity |
| Difficulty multitasking | Anxiety and depression | Noise sensitivity |
| Difficulty problem solving | Impulsivity | Change in sense of smell or taste |
| Slower speed of thought | Change in sexual drive / function | Difficulty with fine coordination |
| Difficulty under pressure | Loss of motivation |
The above list is typical of the more subtle brain injuries. With the more severe injuries additional physical problems may present to include physical disability, significant speech problems and epilepsy.