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Reply from the Author: Dr. Peterson has accused me of one of the few failings from which I truly thought I was immune: providing aid and comfort to “those who file false and exaggerated claims of head injury.” I was apparently led to this failing by three factors.
Mild TBI does not produce DAI “unless there is a period of loss of consciousness of at least many minutes and perhaps hours in duration.” “Many” is in the eye of the beholder. In Gennarelli et al. 2 (Table 5), grade 1 DAI was reported in animals unconscious for 16 to 119 minutes. At milder levels, the injury may not cause actual axonal disruption and subsequent classic neuropathologic findings. Disruption of axonal transport may be the key pathophysiologic disturbance. 10 In any case, relatively mild TBI can produce overt DAI in humans. 11 Animals unconscious for less than 15 minutes had no DAI 2 …
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