# What kind of head injury causes DR?



## MobiusX (Jul 27, 2010)

On what part of the head must I get injured in order for DR to develop? What if I get injured on my forehead?


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## staples (Apr 1, 2009)

MobiusX said:


> On what part of the head must I get injured in order for DR to develop? What if I get injured on my forehead?


Most of the time it has to affect the Temporal Lobe which starts around your left side temple (next to your left eye) and moves back 4 - 5 inches.


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## Visual (Oct 13, 2010)

MobiusX said:


> On what part of the head must I get injured in order for DR to develop? What if I get injured on my forehead?


It can be any part. Brain injuries are varied and unpredictable. Here is one to think about:

Mild whiplash - it has been "calculated that at the level of the foramen magnum, as much as 14,000 lbs. of inertial force is exerted on the spinal cord with a minimal 10 mile an hour rear-end collision. This can cause a dysfunction in the sensory-motor feedback loop and more specifically in the ambient visual process. Although this type of an injury cannot be seen in most cases on a CT scan or MRI"

Fortunately most people do well despite having lots of knocks throughout their life.


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## Guest (Jan 17, 2011)

Mobius, I think you are driving yourself bananas again.

Firstly, many, many people in contact sports get serious head injuries where they are knocked unconscious and don't develop DP/DR. There is apparently a connection with repeated sports head injuries (a longitudinal study of football players in the US) that showed dementia is far more common in these individuals.

I would have to say the head trauma has to be pretty serious for you to experience DP/DR. "Trauma" also includes tumors and such. I believe Dr. Sierra's work at the I.oP. includes an extensive review of individuals with brain tumors who develop DP/DR as a result.

I would say, having DP/DR as the cause of head trauma is in a small group of cases. It's there, but so many people have head trauma, from childhood through their lives -- (auto injuries as Visual Dude mentions) -- well, you'd think you'd see more DP/DR.

When I saw a neurologist for a hand tremor (runs in my family) I asked him about DP/DR. He knew what it was immediately. I asked him how many patients. Don't quote me, but he was working with 5. I think tree had brain tumors, and the other three were in auto accidents so serious they had been thrown from the car or flew through a windshield.

If you think of the Senator of AZ, Gabby Giffords who was just shot in the head by a mentally disturbed man, I doubt she has DP/DR.

It is my sense that the bulk of us here have some sort of anxiety disorder underlying most of this. DP can STAND ALONE, even when the anxiety is not present -- i.e. right now, I'm not anxious and I feel my usual DP/DR that never goes away.

BUT, my goodness, I've landed on my head a lot (after the DP) -- fell off my bike once and bashed my head on a concrete sidewalk. It should have knocked the DP/DR OUT of me ... I literally heard "bells ringing."

And the exact "place" in the brain where DP/DR occurs is I think too complex for anyone to really understand. Different fMRIs etc. show different locations. And as noted the brain is so complex, is so interconnected one can't say THIS is the place. Epilepsy can bring on DP/DR in the "aura" of the seizure ... but in many with epilepsy the focus of the seizure cannot be found.

Also, I would think if you bashed your head, and DP/DR developed from that, it would occur very soon after the event.

Consider how many war veterans now have traumatic brain injuries, and I haven't been reading more reports of DP/DR (chronic like ours) but of PTSD ... which is quite different in the long run.

If you were a boxer, a football player, or in a VERY serious car accident, or you fell out of a tree, etc. I'd be more concerned.


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## Visual (Oct 13, 2010)

*I saw a neurologist for a hand tremor (runs in my family)*

Is this Essential Tremor?


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## Guest (Jan 18, 2011)

Visual Dude said:


> *I saw a neurologist for a hand tremor (runs in my family)*
> 
> Is this Essential Tremor?


Visual yes. Man we all should go to medical school, lol.

It turns out my tremor was caused by a med interaction. This was ... 7 years back, forgot.
My father had a tremor, no indication of Parkinson's and he died of heart failure at the age of 84 so hand tremor is no longer on my list of 800 health concerns. Worst of them all. Still the DP/DR -- interferes most with quality of life.

Oh, and my father had "intention tremor" that is when reaching for something, holding something. We didn't talk much about much. I never asked him what was wrong. Unfortunate. But actually he was the only person I knew who has it in my family, but I don't have much of a family. Sigh.

Feeling sorry for myself again tonight.


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## ohwell (Oct 28, 2010)

Actually, the only study I was able to find about depersonalization and concussions supported that milder concussions without loss of consciousness was associated with depersonalization rather than worst concussions with loss of consciousness. The study concluded that given the results a psychogenic cause of depersonalization after concussion was a lot more probable, as a consequence of a stress disorder associated with the trauma. Loss of consciousness prevented a recollection of the traumatic event. I found that interesting.



Dreamer* said:


> Mobius, I think you are driving yourself bananas again.
> 
> Firstly, many, many people in contact sports get serious head injuries where they are knocked unconscious and don't develop DP/DR. There is apparently a connection with repeated sports head injuries (a longitudinal study of football players in the US) that showed dementia is far more common in these individuals.
> 
> ...


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## Guest (Jan 18, 2011)

ohwell said:


> Actually, the only study I was able to find about depersonalization and concussions supported that milder concussions without loss of consciousness was associated with depersonalization rather than worst concussions with loss of consciousness. The study concluded that given the results a psychogenic cause of depersonalization after concussion was a lot more probable, as a consequence of a stress disorder associated with the trauma. Loss of consciousness prevented a recollection of the traumatic event. I found that interesting.


Interesting. I am only using the example of speaking with a neurologist on a doctor's visit, and I know he mentioned 2 people had auto accidents, and 3 had tumors.

Do you have a link to this study? Was it TRANSIENT DP though, after the injury, or did the DP remain chronic. That's the key. I asked the neurologist specifically about chronic DP/DR.

I should go look this up on PubMed.

I shouldn't have this as a "watched topic" as I'm fascinated, LOL.


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## Guest (Jan 18, 2011)

Good grief I have no memory. I just look in Dr. Sierra's book. Depersonalization: A New Look at a Neglected Syndrome.

See pages 93-95. Bottom line it just isn't well understood.

Study by Grigsby and Kay (1993) most rigorous with detailed follow up of 70 head trauma patients. 50% experienced DP. In 66% those experienced the DP immediately while in 20% onset was delated for 1-14 days. In 50% of the patients the DP remained chronic.

I'll see if I can find the abstract. Is this what you found? There's mention of vestibular problems ... this has come up before re: DP.

Thing is, it seems to me that one can get DP from a relatively serious bonk on the head, but so many people DO get bonked on the head and DON'T get DP. Now I'm confused. At least the neurologist I saw was telling me the truth. And in that sense it would be obvious there is a biological/neurological connection somewhere. Also mentioned is, if you're hit in the head, jiggling the grey matter around could affect so many different areas.

Thanks! MY MIND IS GONE! I'm old.


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## Guest (Jan 18, 2011)

Two good article abstracts from Pubmed

http://www.ncbi.nlm.nih.gov/pubmed/8260954

*Brain Inj. 1993 Nov-Dec;7(6):507-13.
Incidence and correlates of depersonalization following head trauma.*

_*Grigsby J, Kaye K.
Center for Health Services Research, University of Colorado Health Sciences Center, Denver 80222.
*_
Abstract

Using the criteria of the Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D), we assessed the incidence of feelings of unreality among a sample of 70 persons who had sustained head injuries. *Among those whose head trauma could be classified as mild, more than 60% complained of a depersonalization syndrome.*

Among those with a significant period of unconsciousness, only 11% had similar complaints. There was a *high comorbidity with post-traumatic stress disorder and vertigo.* Feelings of unreality were not associated with cognitive impairment or elevated personality test scores, nor were there significant relationships with gender or involvement in litigation.

*A conservative estimate of incidence of depersonalization among persons with minor head trauma is 13%, while, at the upper end, as many as 67% of persons who sustain mild head injury may experience feelings of unreality.*

PMID: 8260954 [PubMed - indexed for MEDLINE]

*Something important to note. Don't have the entire article. Individuals who have DP from head injury -- how long do they have it? Hours, days, weeks. I'm not clear on this. Is it like the 24/7, 365 days a year type that many of us have here? If so, I wonder why only a few people have mentioned head trauma as a reason for this occurring ... just wondering.

------------------------------------------------------------------------

http://www.ncbi.nlm.nih.gov/pubmed/9888147

*Nervenarzt. 1998 Dec;69(12):1100-6.
[Depersonalization syndrome after acquired brain damage. Overview based on 3 case reports and the literature and discussion of etiological models].*

[Article in German]

_*Paulig M, Böttger S, Sommer M, Prosiegel M.
Neurologisches Krankenhaus, München.*_

Abstract

*Depersonalization after brain damage is still only rarely reported and poorly understood.*

We describe three patients between the ages of 21 and 25 who experienced depersonalization and derealization for periods of *6 weeks to 4 months, two after traumatic brain injury, the third after surgical and radiation treatment of a pineocytoma.*

Each one believed to be living in a nightmare and thought about committing suicide in order to wake up.

One patient developed symptoms as described in Cotard delusion.

Aspects of neuroanatomy, psychodynamics, and anthropology are discussed with reference to the literature. *Frontal and temporal lesions seem only to play a facilitating role but not to be a necessary condition.* There is evidence for additional influence of psychological and premorbid personality factors. Summarizing the current state of information we consider depersonalization with the experience of being in a dream or being dead as a heuristic reaction to brain damage. Similar models have already been discussed in neuropsychological disorders as for instance reduplicative paramnesias, neglect, and anosognosia.

PMID: 9888147 [PubMed - indexed for MEDLINE]

I should write Fox and have them do an episode on "HOUSE" with some person with DP. They did have someone with Cotard's on Law and Order once!

My guess is you would have to have sought help or been hospitalized and experienced the DP/DR around the time of an injury to see if there was some relation. We're all unique. There is one young woman on the board here who literally may have DP/DR from head trauma. She doesn't have anxiety, depression, etc. I always get her story wrong ... her name is peachyderanged or peachy ... you can search her posts.


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## real50tyson (Feb 20, 2012)

staples said:


> Most of the time it has to affect the Temporal Lobe which starts around your left side temple (next to your left eye) and moves back 4 - 5 inches.


well ill be darned...a week before my depersonalization/anxiety started i was knocked out unconscious from a hit to the temporal lobe around my left eye...my side temple. Mine was definetely from this because after the concussion i started having anxiety attacks for the first time ever...wchich lead to my depersonalization...but since i got depersonalization i haven't had a anxiety attack.


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