As a personal injury attorney, I have often been concerned about the lack of diagnosis and treatment of traumatic brain injury (TBI) in injured people I represent. Fortunately, we have come to a time when there is more awareness and understanding of the need for medical professionals to address brain injuries. This awareness it is in part of recognition by the NFL of the brain injuries sustained by its football players, the movie Concussion has brought attention to TBI. And, there is increasing research discussing traumatic brain injury and its significance.
The growing body of research is helping accident victims validate their injury and the effects of their injury, when insurance companies try to deny claims, deny medical care, or send injured people to insurance company doctors who make substantial sums of money by routinely claiming they found no injuries. Incredibly, insurance doctors will often cite no findings on a CT scan or MRI as evidence of no brain injury. However, the vast majority of brain injuries do not show up on these scans. Some insurance company doctors will claim there cannot be a brain injury if there was not a significant impact to the head. To get an insurance company to cover necessary treatment, you may need to retain a personal injury lawyer, and bring a lawsuit. This is particularly true in New York no-fault cases and workers compensation cases.
Impact to the head can result in brain injury; however, injury can occur without a blow to the head. Brain injury can occur by a quick acceleration or deceleration of the head, such as in a car or truck crash. If it appears the injury exists more than two or three months, neuropsychological testing may be necessary in order to diagnose any specific deficits.
When there is a traumatic impact there is often what is called a coup-contrecoup injury. It is a common pattern where damage is located at the site of impact, and there may be more damage on the opposite side of the brain. This is because the impact accelerates the skull on the site of the impact and the brain shifts away from the point of impact it hits the internal surface of the skull on the opposite side. The coupe – contrecoup injury is most often associated with cerebral contusions, the inferior surface of the frontal lobes in the temporal poles.
Patient questioning and physical examination are initial tools, although clinical signs may be subtle and difficult to detect. There may be alteration in the ability to think, and remember. Sometimes patients describe “fogginess”; there may be deterioration in coordination and balance. Family members often observed personality changes, such as one’s ability or overly emotional responses.
Traumatic brain injuries can be as a result of car crashes, sports, falls or other unexpected incidents. According to the Brain Injury Research Institute, 1.6 to 3.8 million Americans suffer from sports related injuries per year. That is sports injuries alone. Most people go on to recover uneventfully; however, they may be at a greater risk of future injury. Some injuries are severe enough that there is never full recovery.
If you suspect a loved one may have had a brain injury, seek immediate medical help. In addition to seeing your primary doctor, it may be helpful seeing a doctor who deals with brain injuries. Initially the patient should rest; particularly if he or she is having headaches, nausea or confusion. Limit physical activities and cognitive stimulation. Take note of what may increase symptoms. Avoid re-injury situations, such as going back into a sports game.
If you suspect lingering problems, consult a qualified expert. The good news is that most mild brain injuries result in full recovery.