Brain injury is a big part of our practice.
We’re not neurologists. But it’s important to understand some basics about the brain.
The Basics
Each side of the brain contains four lobes. Each lobe has a different function.
The brain is made up of about 100 million neurons. Neurons have specialized projections
called dendrites and axons. Dendrites bring information to the cell body and axons take
information away from the cell body.
Each neuron may be connected to up to 10,000 other neurons. This means the loss of one
neuron can affect about 10,000 other neurons.
What Causes Brain Injuries?
You don’t have to hit your head to suffer a brain injury. In fact, most brain injuries are not the result of a direct impact to the skull.
Frequently TBIs are the result of acceleration/deceleration (“A/D”) injuries. They cause
damage and functional disturbances to the different types of brain cells.
The brain does not tolerate A/D forces well. It’s what’s called a “viscoelastic” organ. It
has very little internal structural support.
The brain can move forward and back, side to side and/or rotate. Different parts of the brain are affected depending on the different forces involved.
Having the brain bounce around inside the skull is a problem. Even though the skull is designed to protect the brain from direct blows, it’s punctuated with bony hazards on the inside.
Missed Diagnoses
Even a minor brain injury is a big deal. Juries are starting to appreciate it.
But surprisingly more than 50 percent of mild traumatic brain injuries (concussions) are not diagnosed in the ER.
One reason they’re missed is because “mild” traumatic brain injuries (definitionally) don’t show up in x-rays, CT scans or MRIs. So when doctors say “negative findings on imaging” it doesn’t really mean anything. It’s like saying that the wind gauge doesn’t show they’re any humidity. That’s not what it’s designed to do.
A lot of people thing that just because they weren’t diagnosed with a mild traumatic brain injury that it can’t be part of their claim. Even if there isn’t a specific diagnosis in the ER, doctors retained to evaluate injured people can make the diagnosis weeks, months or years later. All it takes is evidence that the injured person had an alteration in consciousness.
An alteration of consciousness means things like confusion, feeling dazed, not being sure what happened or asking the same questions repeatedly.
Getting Better
We tend to oversimplify things. It makes it easier (in most cases) to navigate our busy and complicated worlds.
One way many medical professionals oversimplify is by saying that most people who suffer a brain injury “get better” in weeks or months.
Statistics show they’re (at least partially) right. But that’s as long as you’ve never had a prior brain injury, you’re not a woman, you’re not over 40, you don’t have a history of migraines, you don’t have a history of anxiety or depression, etc.
Many people have symptoms that continue to last over 18 months after an injury. And when symptoms last over 18 months, they’re probably not going to get better.
Another way we oversimplify is by talking about “getting better”. The language is too broad. There’s both natural improvement and functional improvement. Natural improvement is the brain healing. Functional improvement is basically learning to better deal with deficits left by a brain injury.
But irrespective of how much “better” someone gets after having even a mild traumatic brain injury, their brain is always going to be different.
A cut may heal, but there’s going to be a scar. The swelling may go down on a sprained ankle, but the ligament is always going to have some laxity.
Consequences
This theory that the brain is never the same after even a mild traumatic brain injury is borne out by a couple of known facts.
First, everyone knows that successive minor traumatic brain injuries have exponential consequences. Sometimes they’re described as additive, but they’re really more like exponential.
Second, the science shows that even with one mild traumatic brain injury, the risk of dementia doubles. That means that a mild traumatic brain injury leaves a permanent mark on the brain.
Questions and Feedback
If you have questions about how brain injury claims are different than other injury claims or want to discuss a brain injury issue, please get in touch with us. We’d really like to hear from you.
What Clients are Saying
Thanks for all of your support and helping me tell my story with dignity. I feel so much better now. It’s like a weight has been lifted off of me. I can’t describe what it feels like to not have anything hanging over my head
Most people don’t understand that you can have a TBI even if you don’t lose consciousness or hit your head on anything. When my car was hit, it was very scary. It took time to figure out what my deficits were and a lot of work to find the right specialists and get treatment. I am so thankful that Mike and Samantha were there for me and that they understand brain injury. They allowed me to focus on getting better.
I really appreciate that it was you, Mike. Samantha you were wonderful dealing with all my questions and anxieties. I feel that we were in very good hands.