Traumatic Brain Injury (TBI)
Brain injuries go by several different names. Some of these include Traumatic Brain Injury (TBI), concussion, Post Concussion Syndrome (PCS), Closed Head Injury (CHI), intracranial injury, and Acquired Brain Injury (ABI).
Traumatic Brain Injury is trauma to the head, ranging from mild to severe, that disrupts brain functioning. The damage to the brain may be focused in one area of the brain, or may be spread out throughout many areas.
Establishing TBI: General Problems
Dealing with Traumatic Brain Injury following an accident is very difficult. The brain is highly complex, and in many ways, one of the least understood organs of the human body.
Complicating matters is the fact that Traumatic Brain Injury symptoms may not arise immediately after a traumatic car accident or a slip and fall accident, and in fact may take several months or longer for the accident victim to fully appreciate.
Further complicating matters, many less severe Traumatic Brain Injuries may not appear on the results of a CT scan or MRI, and therefore, the accident victim may suffer debilitating injury for which there is no “objective” proof.
Sometimes, the lack of emergency physician follow-up leads to the loss of potential objective evidence of TBI. Oftentimes, emergency care physicians may order a CT scan following a traumatic accident, but if the CT scan does not reveal, for instance, bleeding within the brain, TBI may be ruled out entirely and no further tests may be done. Other times, emergency doctors may ask accident victims whether they lost consciousness, but then fail to follow up this inquiry with a question regarding the patient’s first memory after the accident. This is an important follow-up question, because many TBI sufferers will report no loss of consciousness, but then state that their first memory was at a later time, after the accident and perhaps much later. Similarly, emergency doctors may fail to ask accident victims to report their last memory before the accident occurred. These follow-up questions, often neglected by emergency room physicians, would reveal gaps in consciousness that would help indicate the presence of TBI.
It is important for an accident attorney to be aware of these and many other issues when dealing with cases involving Traumatic Brain Injury. As the plaintiff in a personal injury lawsuit, it is your burden, and your attorney’s burden, to fully prove the case by a preponderance of the evidence. This means that if your case goes to trial, you and your attorney must prove your damages and your injuries. Therefore, if you have suffered a Traumatic Brain Injury in a car accident or as the result of a slip and fall, your injury attorney must be aware of the many unique issues that arise in these types of cases in order to successfully seek maximum compensation for your injuries.
Concussion
Concussion is the most frequent kind of Traumatic Brain Injury suffered by accident victims. No one definition of concussion is universally accepted within the medical community, and in fact, experts disagree as to whether concussion is accompanied by any physical changes within the structure of the brain. Nevertheless, a concussion typically involves temporary loss of neurological function with no obvious structural changes to the brain revealed by CT scan or MRI. A concussion may be minor and temporary or may result in permanent injury. A concussion may or may not involve a temporary loss of consciousness.
TBI and Unconsciousness
Insurance company defense attorneys will likely argue that absent a loss of consciousness, there can be no TBI. An experienced accident attorney knows that this is not true. An accident victim does not need to lose consciousness to have suffered a Traumatic Brain Injury. A TBI victim may lose consciousness, have some loss of memory before or after the accident, or may simply feel dazed and confused. All of these possibilities point to an alteration of mental state indicative of TBI. An experienced accident attorney will investigate whether or not the evidence reveals an alteration of mental state, by questioning not only the accident victim, but any other available witnesses as well, including passengers and emergency care workers.
Diagnosing TBI
The lack of objective results on diagnostic tests such as CT scan or MRIs does not mean that a TBI was not suffered by the accident victim. In fact, many instances of TBI will not be revealed in CT scan or MRI results. If CT scan and MRI do not reveal any structural abnormalities in the brain, the TBI victim’s doctor may order PET or SPECT scan. An experienced injury attorney is aware of these tests and the differences between them.
An MRI uses electromagnets and radiofrequency waves in order to create an image of the internal anatomy. A CT (Computed Tomography) scan creates an image of the body’s internal structures by taking x-rays from several different perspectives. A PET (Positron emission tomography) scan uses a radioactive tracer that is injected into the test subject to a three-dimensional image of the body. A SPECT (Single Photon Emission Computed Tomography) scan uses nuclear technology to allow the treating doctor to detect blood flow through different regions of the brain. All of the above imaging techniques may be used to diagnose TBI.
However, as discussed above, in many instances, TBI does not show up on these neuro-imaging techniques. Accordingly, an experienced accident attorney knows that often, TBI must be established through proving the symptoms of TBI.
TBI Symptoms
Because TBI is not always revealed by “objective” evidence such as MRI or CT scan, an experienced personal injury attorney understands that TBI must often be established by proving the symptoms of TBI. The symptoms of TBI may be any of the following:
- Dizziness
- Headache
- Irritability
- Fatigue
- Loss of concentration
- Loss of memory
An experienced injury attorney will also question any potential witnesses at the scene off the accident or who interacted later with the TBI sufferer. These witnesses may be able to establish that the accident victim suffered a temporary loss of consciousness or a loss of memory indicative of TBI.
Fighting Insurance Company Defense Tactics
Insurance company attorneys hired for the negligent party will often raise the defense of “malingering” in a TBI case. When the insurance company attorneys accuse the plaintiff of malingering, they are essentially accusing the accident victim of intentionally exaggerating or feigning injury.
Insurance company defense attorneys have many techniques they use in order to supposedly establish malingering. These include the use of experts and tests that will supposedly reveal inconsistencies in the TBI sufferers’ answers to certain questions. Experienced accident attorneys can prepare you for the realities of litigation involving TBI, and know how to counter any accusation of malingering.
Oronoz Injury Law can help
If you or a loved one is suffering from an accident related traumatic brain injury, please contact our office for a free consultation. You can reach us via phone at 702-878-2889 or via the contact us forms on this website.
