The full effects of some traumatic injuries take years to completely evolve. One example is traumatic brain injury (TBI).
A young man sustained a severe TBI caused by a fall from a roof. Take a look at the CT images below: image A shows a skull fracture (arrow) just beneath a large amount of swelling. In image B, you can see the location of some bleeding (bottom arrow) and more massive swelling (top arrow).
7.5 years post-injury, the young man reported persistent problems with his memory, initiative, and problem-solving. Images D and E are MRI pictures at this stage. Notice that the outlines of the black areas in the center of the brain (ventricles) are significantly larger than the outline in image B. In other words, there is volume loss in his brain. His brain has atrophied. There are also post-traumatic changes in the brain tissue itself (arrow on image E).
Brain volume loss and post-traumatic changes like those shown here are commonly associated with TBI. Especially with brain trauma, there’s typically much more to an injury than what initially meets the eye.
(Source: Cifu, David X. Traumatic Brain Injury. New York, Demos Medical Pub., 2010)
