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“He got his bell rung.” “He saw stars.” “He was out of it for awhile”

Familiar phrases we’ve all heard and probably used to describe someone who’s just gotten a blow to the head. One thing all these phrases and many others like them have in common is how they trivialize an injury that is anything but trivial. In my dealings with several clients I’ve come to understand just how serious even the most seemingly mundane head injury can be.

One such client that comes to mind was a police officer in Illinois; a man who’d spent thirteen years in uniform without harm, only to be brought down by a freak incident. The officer and his partner were in their department’s booking room, waiting to process an arrestee. The arrestee became unruly, and began fighting with the partner. When my client attempted to help his partner, he was knocked to the floor and struck his head.

After the fracas was brought under control, my client went to the hospital with concussion like symptoms. Despite his pain, he quickly returned to duty, assuming, as I believe many men do, that he could just “shake it off.” Unfortunately, that wasn’t going to happen, and after a week of half-duty he was diagnosed with post-concussive syndrome. Eventually this condition would be enough to end his career with a duty related disability, but not without a fight with his employer.

Post-concussive syndrome (PCS) is what at one time was called “shell-shock,” the term first given to returning WWI vets who had suffered concussive injuries. Now we realize it is a form of traumatic brain injury, and its effects can last from days to years to a lifetime.

The main PCS symptom is headache. While most people have headaches of the same type they experienced before the injury, people with PCS often report more frequent or longer-lasting headaches. Between 30 and 90% of people treated for PCS report having more headaches than they did before the injury, and between 8 and 32% still report them a year after the injury.

Dizziness, the second most common symptom, occurs in about half of people with PCS and is still present in up to a quarter of them a year after the injury. Older people are at especially high risk for dizziness.

About 10% of people with PCS develop sensitivity to light or noise about 5% experience a decreased sense of taste or smell, and about 14% have blurred vision. People may also have double vision or ringing in the ears, also called tinnitus. Loss of hearing occurs in 20% of cases. PCS may cause insomnia, fatigue, sleepiness, or other problems with sleep. Other physical symptoms include nausea and vomiting.

For my client, his most serious lingering symptoms still include short-term memory loss and loss of peripheral vision in his right eye. He was diagnosed by three different physicians, and all agreed that, for all intents and purposes, his career as a police officer was over.

Incredibly, this wasn’t enough for the pension board of the municipality who employed him to initially agree to a line of duty disability pension. Although the issue was eventually resolved in my client’s favor, I believe the reluctance of the pension board was more rooted in our old ideas about head injuries than in the medical evidence. Too many of us, and frankly I’m referring to men, think a blow to the head is nothing to get worked up about, and, just as my client believed, you can simply “shake it off.”

Truth is, you can’t, and even the most innocuous smack to the noggin can have a serious and long-lasting effect. My association with this case and others like it have made me very aware of the dangers posed by head injuries, but even more so the dangers of ignoring or minimizing those injuries.

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