A traumatic brain injury (TBIs) generally results from a sudden blow, bump, or concussive force to the head that disrupts the normal functioning of the brain. The severity of a TBI can range from mild to severe—and the effects can last from a few minutes to a lifetime.
Oftentimes, when a person is involved in an accident they feel sore afterward; most times, they feel pain in their neck or their back. These are common injuries. But sometimes accident victims experience head pain following an accident. This can be because they hit their head during the accident on a steering wheel or a window, or because their head was jerked around so much during the accident. When these types of pain surface, it is always a good idea to be evaluated for a potential traumatic brain injury. This article will explain to you what a traumatic brain injury is, how they are caused, and what sort of treatment you could expect moving forward.
What is a Traumatic Brain Injury?
A traumatic brain injury (TBI) is a form of brain injury caused by sudden damage to the brain. The Centers for Disease Control and Prevention have identified the leading causes of TBI to be falls, motor vehicle, and pedestrian-related accidents, collision-related (being struck by or against) events, and violent assaults. Usually, during an accident, this damage is caused when you hit your head against something inside the car when you were struck.
This damage usually results in two different types of damage: primary and secondary trauma. The first of these is known as primary brain damage. This sort of damage takes place at the moment of impact and usually consists of skull fractures, bleeding in the brain, and blood clots. Then there are secondary brain damages. These damages usually develop some time after the accident and are not immediately noticeable. They can include increased blood pressure within the skull, seizures, and brain swelling.
Symptoms of a Traumatic Brain Injury Include
- Memory problems
- Orientation Issues
- Concentration problems
- Attention difficulties
- Blurred vision
- Uneven gait
- Emotional ability
- Loss of initiative
- Sleep disturbances
Head injuries have received increased media attention over the last two years due to the rash of concussions suffered by professional athletes (particularly football players in the NFL). These injuries can be very subtle and often go undiagnosed. Further, the amount of impact necessary to result in a brain injury is not as much as one would imagine.
I have referenced the website braininjury.com for the following excerpt: “How much force is necessary to cause permanent brain damage is under study, and hence still unclear. Over the years, professional boxers suffer permanent brain damage. The force of a professional boxer’s fist is equivalent to being hit with a 13-pound bowling ball traveling 20 miles per hour, about 52 g’s. Plopping down into an easy chair can generate up to 10 g’s. So, it seems that somewhere between 10 and 50 g’s is the threshold to permanent brain injury. This does not mean that accelerations over 50 g’s have to cause permanent brain damage. Football players are subjected to 200 g’s, and Indy race car drivers have been subjected to 80 g’s without permanent injury, but they were wearing helmets.
Football players and race car drivers also protect their heads from being whiplashed. Whiplash seems to be particularly damaging to the brain. Woodpeckers smack their heads against trees with 1200 g’s of force without suffering brain damage. Part of the reason is that they keep their heads in the plane of their body; the head does not rotate in a “yes-no” manner during the pecking. If there were some way to stabilize the head when driving – akin to wearing a mail suit from the Middle Ages – more people would walk away from automobile accidents without serious brain injury.”
There are two main methods that a brain is susceptible to significant trauma. If an individual’s head strikes an object the cerebral cortex can become contused/bruised or in the event where the head is whiplashed it is very possible that the deep white matter may suffer an axonal tear. When the axons are stretched or torn they can be damaged for good. Many attorneys fail to recognize that their clients may have indeed suffered a brain injury and instead focus on the more obvious general orthopedic ailments. This often occurs in cases in which the client did not suffer a significant closed head injury (i.e. their head did not strike an object and they did not lose consciousness). Failing to lose consciousness does not rule out the possibility that a traumatic brain injury occurred.
How will I know if I have a traumatic brain injury?
After an accident, if you feel as though you may have a traumatic brain injury, it is important to get evaluated immediately. The easiest way for a physician to determine whether or not you have a brain injury is to undergo an imaging study such as a CT scan or an MRI. Based on these results, a physician will then be able to tell whether you have suffered an injury or not.
If the physician determines that you have suffered a traumatic brain injury, the next step would be to get you set up with a team of doctors and professionals who specialize in treating victims of a traumatic brain injury. Depending on your individual needs, you may meet with a pathologist, a neuropsychologist, a physical therapist, a speech-language pathologist, etc.
What are some of the problems you may experience after a TBI?
Each case is different meaning traumatic brain injury symptoms can manifest in different ways. It all depends on which area of the brain was affected. It is possible that you may have physical issues which can include headaches, seizures, issues with balance, issues with coordination, vomiting, nausea, etc. A person may also experience sensory deficits. These can result in a person becoming unbalanced and being unable to locate themselves in relation to other objects around them.
The next kind of changes a person could experience is behavioral changes. A person who has behavioral changes is likely to feel more depressed, agitated, or frustrated. One major area that should be a huge cause for concern is if you notice that you are having trouble with communication. If you find yourself having trouble communicating correctly, slurring your words, or having any difficulty spelling or writing after your accident, you may be suffering from communication deficits as a result of the traumatic injury to your brain.
Mild Traumatic Brain Injuries Symptoms
Mild TBIs, often called concussions, generally involve a change in mental status or a loss of consciousness that lasts for less than 30 minutes—and people who have suffered mild traumatic brain injuries generally achieve scores of 13 to 15 on the Glasgow Coma Scale. MRIs and CAT scans may reveal no obvious damage in people who suffer mild traumatic brain injuries, but concussion victims may still experience:
- Change in sense of smell or taste
- Inability to concentrate
- Loss of balance
- Loss of concentration
- Memory loss
- Mood changes
- Sensitivity to light and sound
- Slurred speech
- Vision issues
Symptoms associated with mild traumatic brain injuries may not appear for days or weeks. As a result, doctors don’t diagnose many mild TBI cases until long after the precipitating injuries and do not diagnose others at all.
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Moderate Traumatic Brain Injuries Symptoms
Moderate TBIs generally involve many of the same symptoms as mild ones, except they do not go away as quickly—or they worsen with time.
People who experience moderate traumatic brain injuries may lose consciousness from 20 minutes to six hours, and generally score a nine to 12 on the Glasgow Coma Scale.
Severe Traumatic Brain Injuries Symptoms
Severe TBIs generally involve the loss of consciousness for more than 6 hours—and a score on the Glasgow Coma Scale of three to eight. As with moderate TBIs, the impact of a severe traumatic brain injury depends on:
- The severity of the initial injury
- The specific, disaffected physiological functions
- The physiological functions that the injury did not damage
- The completeness of the recovery
- The resources available for rehabilitation and recovery
Severe traumatic brain injuries often result in neuro-biological damages that cause permanent loss—or a permanent lessening—of cognitive or sensory functions. These may include any or all of the following:
- Language processing
Severe traumatic brain injuries can also result in emotional and psychological changes for the injured parties. Examples include:
- Emotional dependence
- Lack of awareness
- Lack of motivation
- Mood swings
- Finally, severe traumatic brain injuries can result in physical changes—including, but not limited to:
- Appetite changes
- Chronic pain
- Lost bladder and bowel control
- Regulation of body temperature
- Sleep disorders
Traumatic Brain Injury Causes
Traumatic brain injuries are caused by some kind of severe force acting upon the head. Usually, this will consist of a physical blow to the skull that can take the form of a dashboard someone hits their head on in an accident, hitting your head on the ground when falling, or some kind of debris falling or being flung into the skull at high speeds. While direct physical trauma is more common, traumatic brain injuries can also be inflicted by severe forces caused by intense jerking of the head such as in an accident where a head can snap quickly because of the sudden acceleration caused by a collision with an object.
There are a disturbing number of people that fail to seek medical care for traumatic brain injuries because they fail to heed warning signs but also because they don’t consider the blow to their skull strong enough to inflict such an injury. Regardless of the perceived strength of a blow to your head, you should always seek the help of a medical professional after suffering a blow to your head.
The severity of the injury and the injured party’s ability to obtain treatment and rehabilitative services will dictate how a doctor treats a traumatic brain injury. As a result, an appropriately trained physician must diagnose the type of TBI that the patient endured—and determine the appropriate treatment plan for the injured person.
Mild traumatic brain injuries may require nothing more than rest and over-the-counter medications to treat headaches. Even in the case of mild TBIs, however, closely monitor the injured party for several days for any persistent, worsening, or new symptoms.
Moderate traumatic brain injuries often require extended periods of inactivity and prescribed medications. In addition, a moderate TBI may take several weeks of gradual recovery.
Recovery from severe traumatic brain injuries varies according to the type and severity of the injuries—and the condition of the people before their head traumas. Someone who suffered a severe TBI always requires the oversight of a trained physician who can develop an individualized treatment plan and who can, thereafter, monitor the injured party’s progress or regression.
Several theories try to explain how a severely traumatized brain recovers functionality. These include:
Diaschisis: Uninjured areas of the brain that are linked to injured areas regain functionality.
Replacement: Areas of the brain that normally do not perform certain functions take them over from damaged areas of the brain that normally do.Redundancy: Several areas of the brain can perform the same functions, so one area of the brain takes over duties that the injured area previously performed.Behavioral substitution: The injured individual learns new ways to compensate for lost functionality.
TBI Damaging Effects
Because severe traumatic brain injuries often require long-term care and treatments, they can leave ruinous impacts on injured parties and their families. TBIs may instantaneously and forever change responsibilities and damage relationships. Life is never the same after someone has suffered a severe traumatic brain injury.No one is ever prepared to deal with the consequences of a severe traumatic brain injury—either to themselves or to a family member. The fear and urgency that occur at the time of the injury, the ambiguity and uncertainty that arise once it is clear that the injured party will survive, and the anxiety and stress that take place as afflicted parties deal with the long-term consequences of the injury all place enormous burdens on the entire family.
Symptoms of Traumatic Brain Injury Can Persist for Years
Physicians have long believed that if you hit your head during a car accident or while playing sports, then the concussion symptoms; dizziness, memory loss, headaches, would disappear with a little rest and relaxation. A new study conducted at the University of Oklahoma has suggested that the effects of combat-related traumatic brain injury (TBI) can persist for years without any decreasing severity.
The research study, which was revealed at the annual meeting of the American Headache Society last month, evaluated 500 veterans who battled in the wars in Iraq and Afghanistan. The subjects had screened positive for TBI during deployment between June 2008 and April 2011. The veteran victims were being treated at a special traumatic brain injury department at the Oklahoma City Veteran Affairs Medical Center.
A further level of testing administered to the veterans attempted to evaluate the persistence and intensity of head injury symptoms including depression, lack of coordination, and issues with judgment. As a whole, those symptoms are known as post-concussion syndrome.
Researchers arranged the data according to whether the veterans had sustained a TBI injury within the previous four years, or five to eight years before the screening took place.
The results were discouraging. Not one of the symptoms of post-concussion syndrome seemed to improve over the previous eight years. Almost half of the veterans who had endured a TBI within the past four years disclosed that they were still having mild-to-moderate headache pain. About 46% reported that they were experiencing severe headaches.
Those numbers were nearly identical for veterans who had experienced TBI five to eight years before, with roughly 45 % claiming they were still having mild headaches and 51% saying they had severe headaches.
The same pattern appeared in the data set for five other symptom types stemming from post-concussion syndrome: dizziness, balance, coordination, decision making and depression. The majority of veterans participating in the study screened positive for all of the symptoms above,excluding depression.
“These results prove we’re not seeing recovery in veterans with these head injuries,” stated Dr. James R. Couch, a respected professor of neurology at the University of Oklahoma and the lead author of the study. “In fact, there is a tendency that things are getting just a little worse.”
Dr. Couch believes closed-head injuries could be particularly dangerous because the veterans with TBI look normal on the exterior, but on the inside are sustaining pain or cognitive problems that can entirely disrupt their normal lifestyles.
He said that the observed symptoms worsened for those veterans who had suffered more than one TBI, suggesting a cumulative impact of head injuries. Previous research has also supported this claim.
Many of the 500 veterans evaluated had received their brain injuries from explosions. However, Dr. Couch stated that the data did not seem to vary significantly with veterans who had TBI from other sources, such as automobile accidents.
Symptoms associated with TBI contribute to the complexity of treating the injury
Since some symptoms are psychiatric and others physical, numerous medications and therapies are suggested for each. Veterans with post-concussion syndrome may also require additional services to find employment or salvage marriages, Dr. Couch explained.
“We have to recognize that people who may have head injuries may look the same, but they are not going to act the same,” Dr. Couch said. “You’ve got to stabilize the patient’s interaction with family and try to create the best environment for the patient to be able to return to employment, stay with the family and return to self-respect.”
Dr. Couch also noted that the researchers considered the odds that some veterans only reported ongoing symptoms so that they could continue receiving disability compensation.
He termed the above hypothetical occurrence “compensationneurosis,” and said its existence has been debated since the 1880’s, when a German researcher found that the number of people who reported being hurt in railway accidents exponentially increased after the government began to pay out compensation for such injuries. However, Dr. Couch said that there is also sufficient evidence that people generally do not report physical injuries based on whether compensation is involved or not.
A shortcoming of the study, which was partially financed by the Department of Veterans Affairs, was that it was retrospective and did not include follow-ups with the veterans, said Dr. Couch. As a result, events after deployment, including problems with alcohol or drugs, or even new injuries, were not taken into consideration.
Future research studies should focus on observing a group of veterans with post-concussion syndrome over many years, not only to determine which symptoms persist the longest, but also which therapy treatments are most effective.
Research studies should also observe whether veterans with head injuries develop chronic traumatic encephalopathy, a severe brain disease that was once primarily associated with contact sports but has recently been diagnosed in younger combat veterans.
“Early recognition and early treatment is a major issue here,” he said. “If we treat these people early, we get a much better result.”
Anyone showing signs of moderate or severe TBI should seek medical treatment immediately. Because little can be done to reverse the initial brain damage resulting from trauma, doctors try to first stabilize an individual with TBI and then focus on preventing any further injury. Major concerns include insuring sufficient oxygen supply to the brain and the rest of the body, maintaining blood flow, and controlling blood pressure levels. Imaging tests help in determining the diagnosis and prognosis of a TBI victim. Patients with mild to moderate injuries may receive X-rays to check for bone fractures. For more moderate to severe cases, the imaging test used is a computed tomography (CT) scan. Moderately to severely injured TBI patients also receive rehabilitation that consists of individual treatment plans in the areas of physical therapy, occupational therapy, speech/language therapy, psychiatry, and psychology.
Call a Clearwater Personal Injury Lawyer for Help Today
If you suffered a traumatic brain injury, you know the difficulties you face in your recovery. For legal assistance defending your rights, contact the attorneys at The Dolman Law Group Accident Injury Lawyers, PA.
We have experience working for the benefit of clients who have endured this type of injury and will fight to recover your just compensation. Give us a call at (727) 451-6900 or contact us online.