### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have numerous signs of TBI, dizziness, memory loss, anxiety, deppression.... I was injured in a car wreck in Germany back in 1993. I am just now really starting to have these sypmtoms really appear. I have an appt with the VA for a evaluation. What should I ask/request when I am talking to the doc? I dont remember ever having x-rays but I think I would rather have a ct scan, would this be asking for the wrong thing?

### output:

Hi. I am sorry to hear your account and I completely empathize with you on this. TBI can leave have long term ill effects, particularly on memory, attention and concentration, with anxiety and depressive symptoms and a feeling of dizziness and vertigo long after the actual injury, and though the symptoms appear to be related to the severity of the precipitating injury based on the level of consciousness at 30 minutes after the injury, it can occur even in the absence of any loss of consciousness. In many TBI cases, the common imaging findings are negative for injury to brain parenchymal. Of course, if their if hemorrhage or fracture of the skull, they could be seen, but not the other more subtle injuries. X-ray is an outdated investigation for TBI. CT brain is indicated in acute stages and for follow-up imaging, to see for any residual structural changes in your brain in the last 20 years. An MRI brain scan with functional MRI (if available) would surely give a greater insight into the functionality of the various areas of your brain. At the same time, guidance towards complete neuropsychological evaluation from a competent clinical psychologist is also advised to assess you clinically and match clinical findings with imaging results. Hope this helps