Myths and Facts About Traumatic Brain Injury
Traumatic brain injury can be the most devastating consequence of a motor vehicle crash, a sports injury, an assault or a fall. Brain injury survivors face years of intensive and costly rehabilitation. Many will require therapy and support for the rest of their lives. The toll on families is enormous.
Amazingly, insurance adjusters, judges and juries regularly deny head-injured people the compensation they need to rebuild their shattered lives! Athletes and car crash victims with serious concussions are not taken seriously. "He got his bell rung." "She saw stars." "It's just a minor concussion." Serious brain injuries are sometimes belittled and ignored.
The vast majority of brain injuries are initially diagnosed as mild. Until recently most doctors, personal injury lawyers and crash victims knew very little about the long-term consequences of Mild Traumatic Brain Injury (MTBI). Subtle but permanent changes in intellect, cognition, emotion, memory, concentration and personality were blamed on everything but the MTBI which initiated the changes
REPRESENTING BRAIN INJURY SURVIVORS
Only experienced personal injury attorneys with a clear understanding of the needs of brain injury survivors should provide legal representation in a traumatic brain injury case. This is particularly true if the initial diagnosis was "a concussion " or some other form of mild traumatic brain injury.
Even today, many MTBI cases are decided on myth and misinformation rather than medical facts. Insurance companies and adjusters have a vested interest in perpetuating these myths as a way to avoid paying valid claims.
If you or a loved one has suffered a traumatic brain injury, ask your personal injury lawyer whether he knows the truth about the five myths that prevent adjusters, judges and juries from finding the truth. Does your attorney know how to overcome those myths? Will justice be done in your particular case?
At Velletta & Company we have been representing brain injury survivors for nearly two decades. You can click here to email our office.
FIVE MYTHS ABOUT TRAUMATIC BRAIN INJURY
Myth no. 1
A person must be knocked out or lose consciousness to suffer a brain injury.
This is untrue. People suffer brain injury every day without losing consciousness. In one well-known case, Phineas Gage suffered a severe frontal lobe injury when an explosive charge propelled a long iron bar into his skull. It entered through the lower left side of his face. He sat conversing with his fellow railway workers, the tip of the bar protruding from the top of his skull, until help arrived. He never lost consciousness.
Although Gage appeared to make a "complete " recovery, he suffered profound personality changes which cost him his job, his family and his mental health. There is no necessary connection between loss of consciousness and brain injury.
Myth no. 2
A person must strike his head on something to sustain a traumatic brain injury.
This is untrue. Brain injury leading to permanent damage and even death can occur in the absence of any blow to the head. Shaken baby syndrome and severe whiplash are only two examples of brain injuries where there has been no evidence of a blow to the head. Sudden acceleration/deceleration can cause the brain to strike the inside of the skull with sufficient force to cause bruising and shearing injuries, particularly to the frontal lobes.
Myth no. 3
Minor head injuries such as whiplash or concussions in sports are purely transitory events and cannot cause long term disability.
This is untrue. Even minor head trauma can lead to long-term cognitive, emotional, intellectual and memory problems. This is particularly true where there has been significant acceleration/deceleration of the head (whiplash, shaken babies). It is not even necessary that the blows be repeated -- as in boxing -- although the risk of permanent injury increases with each incident.
Myth no. 4
People who complain of long term consequences after minor head injuries are mostly malingerers and hypochondriacs.
This is untrue. It is estimated that as many as 10-15% of persons who suffer a concussion may have long term changes affecting cognition, intellect, emotions, and personality. Such delayed symptoms are often overlooked or misdiagnosed, even when there was solid evidence of brain injury at the crash scene (concussion, shock, disorientation, post-traumatic amnesia, even loss of consciousness)
Myth no. 5
There is no objective evidence that Mild Traumatic Brain Injury and long-term complications such as Post Concussion Syndrome even exist. They're just terms invented by crafty lawyers representing greedy crash victims.
This is untrue. Sophisticated imaging techniques using Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) can often detect the small lesions typical of mild traumatic brain injury (MTBI). Neuropsychological testing can document the subtle cognitive, emotional, intellectual and personality changes characteristic of MTBI. Human autopsies and animal experiments have also demonstrated the microscopic stretching and tearing of nerve fibres in the brain typically seen in cases of MTBI.
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CLINICAL DEFINITION OF MILD TRAUMATIC BRAIN INJURY
This consensus definition of MTBI was developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. It first appeared in the Journal of Head Trauma Rehabilitation - 1993:8(3):86-87
A patient with mild traumatic brain injury is a person who has had a traumatically induced physiological disruption of brain function, as manifested by at least one of the following:
- any period of loss of consciousness;
- any loss of memory for events immediately before or after the accident;
- any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused); and4. focal neurological deficit(s) that may or may not be transient.
But where the severity of the injury does not exceed the following:
- post-traumatic amnesia (PTA) not greater than 24 hours.
- after 30 minutes, an initial Glasgow Coma Scale (GCS) of 13-15; and
- loss of consciousness of approximately 30 minutes or less.
This definition includes: 1) the head being struck, 2) the head striking an object, and 3) the brain undergoing an acceleration/deceleration movement (i.e. whiplash) without direct external trauma to the head. It excludes stroke, anoxia, tumor, encephalitis, etc.
Computer tomography, magnetic resonance imaging, electroencephalogram, or routine neurological evaluations may be normal.
Due to the lack of medical emergency, or the shortcomings of certain medical systems, some patients may not have the above factors medically documented in the acute stage. In such cases, it is appropriate to consider symptomatology that, when linked to a traumatic head injury, can suggest the existence of a mild traumatic brain injury.
The above criteria define the event of a mild traumatic brain injury. Symptoms of brain injury may or may not persist, for varying lengths of time, after such a neurological event.
It should be recognized that patients with mild traumatic brain injury can exhibit persistent emotional, cognitive, behavioural, and physical symptoms, alone or in combination, which may produce a functional disability. These symptoms generally fall into one the following categories, and are additional evidence that a mild traumatic brain injury has occurred:
- physical symptoms of brain injury (e.g., nausea, vomiting, dizziness, headache, blurred vision, sleep disturbance, quickness to fatigue, lethargy, or other sensory loss) that cannot be accounted for by peripheral injury or other causes;
- cognitive deficits (e.g., involving attention, concentration, perception, memory, speech/language, or executive functions) that cannot be completely accounted for by emotional state or other causes; and
- behavioural change(s) and/or alterations in degree of emotional responsivity (e.g., irritability, quickness to anger, disinhibition, or emotional lability) that cannot be accounted for by a psychological reaction to physical or emotional stress or other causes.
Some patients may not become aware of, or admit, the extent of their symptoms until they attempt to return to normal functioning. In such cases, the evidence for mild traumatic brain injury must be reconstructed.
Mild traumatic brain injury may also be overlooked in the face of more dramatic physical injury (e.g., orthopedic or spinal cord injury). The constellation of symptoms has previously been referred to as minor head injury, post-concussive syndrome, traumatic head syndrome, traumatic cephalgia, post-brain injury syndrome and post-traumatic syndrome.