Traumatic Brain Injury Attorney

Myths About Brain Trauma

As a traumatic brain injury lawyer, I have personally heard these myths, either from clients or from other brain injury lawyers. Let’s go over some of the more common myths:

Myth: You Must Lose Consciousness or Strike Your Head

The human brain has the consistency of jello. In a car accident, the brain can move rapidly though the course of a rigid skull lined with numerous bony protrusions. The brain can bounce off the skull and hit the opposite end of the skull resulting in a coup-countrecoup injury.

This myth is also disproven in instances akin to a whiplash mechanism of injury wherein the head jerks forward and the movement suddenly ceases. Whiplash has been shown in certain cases to cause a disruption in the nerve cells of the brain, responsible for sending messages.

Myth: A Negative MRI or CT-Scan Illustrates There is no Brain Injury

Diagnostic testing has greatly advanced over the past twenty years. However, microscopic lesions in the brain and damage to the neurons can often be missed on an MRI. This fallacy pushed by insurance adjusters must be countered immediately. Neurologists will rely on the medical history of the patient and their clinical presentation. In fact, it is quite common to have a negative MRI yet manifest with cognitive or functional impairment during neurological or neuropsychological testing.

Myth: You Will Quickly Recover From a Brain Injury

Claims adjusters and insurance defense lawyers often attempt to minimize the extent of a brain injury by alleging that the ailment is minor and the claimant will quickly recover. Some symptoms of brain injury are minor and subtle such as memory issues. “At one year after injury, 10-15% of mild TBI patients have not recovered. Many are more symptomatic than even immediately after the injury. Some have had persistence of one particularly troubling symptom usually headache, neck pain or dizziness. Most have persistence and even worsening of the entire symptom complex. Both groups are at a high risk of permanent symptomatic persistent post-concussive syndrome.”

Types of Traumatic Brain Injuries

Concussion

The most common type of brain trauma, both closed and open head injuries can result in concussions. They are often caused by impacts to the head, violent shaking of the head, or whiplash type movements. A concussion often results in post-concussion syndrome; a very serious disorder which can last for months and even in excess of a year. Concussions are often referred to as a mild traumatic brain injury (MTBI).

Symptoms of post-concussion syndrome include:

1. dizziness
2. headaches
3. anxiety
4. difficulty sleeping

1. irritability
2. inability to concentrate
3. depression
4. memory loss

A concussion must never be ignored and warrants immediate medical attention. Post-concussion syndrome can greatly inhibit your ability to perform tasks and may interfere with your job functions. We often see the incidence of concussion either ignored or overlooked by attorneys and physicians who opt to focus on the more obvious and readily apparent orthopedic injuries.

Most individuals with concussions recover after a short to moderate period of time aided by rest. Neurologists often play a crucial role in assisting a patient with post-concussive syndrome in both the evaluation and treatment of minor mental health and cognitive issues. Diagnosis of post-concussion syndrome is based on the patient’s history of head trauma, results of both a physical and neurological examination, and perhaps other diagnostic tests to rule out the presence of a more serious brain injury. Risk factors for post-concussive syndrome are increased by age of the patient and history of prior concussions.

If a second concussion occurs prior to the symptoms resolving from the initial concussion; second impact syndrome (SIS) can occur. An occurrence of second impact syndrome; is marked by rapid swelling of the brain, which may prove fatal. Even a minor concussion can cause secondary impact syndrome. Secondary impact syndrome often proves to be fatal and will result in a debilitating condition at a minimum.

Contusion

A contusion is a direct result of an impact to the head resulting in severe bruising or bleeding of the brain. A cerebral contusion by definition is a bruise to the brain tissue. Large contusions often require surgery. Keep in mind that a cerebral contusion can be related to blood vessel leaks and microhemorrhages. Contusions generally occur in the cortical tissue under the site of where the impact took place. Contusions with edema (swelling) often require surgery to reduce intracranial pressure which can be life-threatening or result in permanent brain damage. Contusion related symptoms depend both on the location (sphere of the brain) of the pathology and obviously the severity of such. In moderate to severe contusions, the swelling is usually greatest at five to six days following the trauma. This is due to swelling of the brain tissue surrounding the site of the impact. Additionally, toxins are released due to the contusion increasing the rate of swelling.

Coup-Contrecoup

Coup-Contrecoup is a result of two contusions on both sides of the brain. The first contusion is a result of the initial impact to the head. The second contusion is a result of the head being hit with such force that the brain slams against the other side of the skull. A coup injury occurs directly under the area of impact. A contrecoup injury occurs on the side directly opposite the impact. In a coup-contrecoup brain injury, both sides of the brain are damaged.

Diffuse Axonal Injury

Diffuse Axonal Injury occurs when the brain lags behind the movement of the skull, thus tearing parts of the brain. This often is a result of an intense shaking or twisting of the head, such as a car accident. A diffuse axonal injury to the brain can cause severe problems and even death. Diffuse axonal injury is caused by shearing forces such as an acceleration-deceleration mechanism of injury akin to whiplash. This occurs when the head moves forward in a rapid manner (acceleration) and then backward or a sudden stop (deceleration). Individuals with diffuse axonal injury typically lose consciousness at the time of trauma. The back and forth movement of the brain disrupts the nerve cells and inhibits the ability of the cells to transmit messages.

Penetration

An injury that forces matter from the skull into the brain. It is a result of a gunshot wound, stabbing wound, or any other sharp object. Often these types of brain injuries can result in death.

Hematoma or Blood Clot

A mass of blood or pronounced swelling between the skull and the brain. In some cases, the swelling or mass of blood occurs inside the brain.

Sudden Attention to Brain Trauma

The most popular professional sports league in America, the N.F.L., has been making headlines lately for settling with a group of former players. The suit will provide them with compensation for medical bills and other needs if a player currently suffers, or later develops, a severe neurological condition as a result of repeated TBIs.

These unfortunate former football players are experiencing, for the first time, the severe effects of untreated or misdiagnosed, repeated closed head injuries. The repeated injuries have resulted in dementia, Alzheimer’s disease, Lou Gehrig’s disease, severe depression. It is tragic that the suffering of our former gridiron heroes is what finally made the public pay attention to the severity of closed head injuries.

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