Traumatic Brain Injury Symptoms and Diagnosis
A traumatic brain injury (TBI) – also known as an acquired brain injury or, more simply, head injury – is caused by a blow or jolt to the head, or a penetrating head wound that disrupts the brain’s normal function and damages the organ.
Traumatic brain injuries can occur when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue.
Traumatic brain injuries may be the result of a
- car wreck,
- trucking accident,
- motorcycle accident,
- work accident,
- defective product, or
- an accident due to a dangerous condition on personal property.
When a TBI is caused due to the negligence of another, you need a SC traumatic injury lawyer to ensure that your rights are protected and that you received the compensation that you deserve.
Traumatic Brain Injury Symptoms
Many people injured in car accidents can suffer from traumatic brain injuries without immediately apparent symptoms. You do not have to hit your head on something like the steering wheel or windshield to suffer a brain injury. You don’t even have to drive fast to obtain a head injury in an accident.
Even at moderate rates of speed, traumatic brain injuries can occur. You may not even know that you have a traumatic brain injury until well after the accident has occurred.
People who suffer from traumatic brain injury need aggressive legal representation to pursue a case. Brain injury litigation is very complex and unique. It requires lawyers that are experienced and familiar with the medical and legal issues involved.
What Causes a Traumatic Brain Injury?
There are three separate processes that can cause traumatic brain injury:
• Bruising (bleeding): In the event of a blow to the head, or even a hard jolt (such as might happen in a car accident), a person’s brain is propelled against the hard bone of the skull, causing blood vessels to tear. When blood vessels tear, they release blood into areas of the brain. Because there is no room for extra blood inside the skull, the delicate brain tissue is compressed. If the pressure is too great and sustained, the tissue will stop working properly, and may even die off.
In car accidents, the force of a crash (or even stopping violently) can throw the soft tissue of the brain against the front part of the skull, causing bruising to the brain. Further injuries occur as your body is thrown back against the seat – this is usually referred to as “whiplash.” When your body flies backward, so does the brain. After your brain bounces against the front of your skull, it is then propelled back to bounce against the back of the skull, causing bruising in different parts of the brain. Thus, people can have bruising not only where their heads may have hit the steering wheel or windshield, or flew forward from braking, but in other areas of the brain as well. These injuries are often referred to as “contra coup” injuries.
• Tearing: This forward-backward jarring of the brain can also tear the brain tissue. This is very serious, as a tear in the tissue essentially “cuts the wires” that make the brain work. Tearing happens on a microscopic level and may not show up on typical medical tests, such as a CT scan or MRI.
• Swelling: Like any other part of the body, the brain will swell in response to injury, as the body sends agents to heal the damaged area. However, there is no extra room inside the skull for the swelling. As with bruising/bleeding in the brain, the swelling will exert pressure on the sensitive brain tissues and damage them – sometimes permanently.
Not all blows or jolts to the head result in a TBI. The severity of injury may range from mild (i.e., a brief change in mental status or consciousness) to severe (i.e., an extended period of unconsciousness or amnesia after the injury).
What Can Cause Traumatic Brain Injury?
Who suffers from head trauma? Theoretically, everyone is at some risk. In 2015 The Centers for Disease Control (CDC) estimates an average of 1.7 million people per year suffer some type of TBI. However, CDC statistics indicate that males between ages 15 and 24 years of age tend to be more vulnerable because of their higher-risk lifestyles.
Young children and individuals over 75 years of age are also more susceptible to head injury, largely due to falls around the home. Violent shaking of an infant or toddler is another significant cause for traumatic brain injuries in children. The leading causes of TBI among adolescents and adults are automobile and motorcycle accidents, though injuries that occur during violent crimes are also a major source.
According to the CDC in 2002 – 2006 falls account for 35.2% of total TBI, while traffic accidents (including those involving motorcycles, bicycles and pedestrians) account for 17.3%. TBI resulting from the head being struck by or against another object (including ATV accidents) make up 16.5% of cases. Assaults account for 10% of TBI. Unknown 21%.
Regarding traffic and ATV injuries, it is important to note that speeding is not a prerequisite for a head injury. Even at moderate rates of speed, TBI can occur. The head also does not have to be hit against an object; jolting injuries can still damage the brain.
Babies and very young toddlers sometimes suffer “shaken baby syndrome,” a type of TBI that occurs when a baby is violently shaken, causing the fragile brain to bounce back and forth inside the skull. The resultant bruising, swelling, and bleeding can lead to permanent, severe brain damage, or death. Injuries – including bleeding in the brain and retina, damage to the spinal cord and neck, and fractures of the ribs and bones – may not be immediately noticeable. Symptoms of shaken baby syndrome include extreme irritability, lethargy, poor feeding, breathing problems, convulsions, vomiting, and pale or bluish skin.
What are the Symptoms of Traumatic Brain Injury?
Other types of TBI share certain sets of symptoms, with variations depending on the type and severity of injury. Particularly in the case of milder injuries, symptoms may not appear at the time of injury – they may show up for days or even weeks. Symptoms can be very subtle as well, and missed by the injured person, his or her family, and even doctors.
Common symptoms of a brain injury include:
- Blurred vision or tired eyes;
- Ringing in the ears;
- Bad taste in the mouth;
- Fatigue or lethargy;
- Changes in sleep patterns;
- Behavioral or mood changes; and
- Trouble with memory, concentration, attention, or thinking.
Mild traumatic brain injuries are defined by loss of consciousness and/or confusion and disorientation for less than 30 minutes.
A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and confusion, restlessness, or agitation.
Anyone with signs of moderate or severe TBI should receive medical attention as soon as possible. Because little can be done to reverse the initial brain damage caused by trauma, medical personnel try to stabilize an individual with a TBI and focus on preventing further injury. Primary concerns include ensuring proper oxygen supply to the brain and the body, maintaining adequate blood flow, and controlling blood pressure.
What are the treaments, prognosis, and long term effects of traumatic brain injury?
Though many TBI victims do not require hospitalization, according to CDC data roughly half of patients with severe TBI will need surgery.
The treatment does not end in the hospital. Moderately to severely injured patients must undergo individually tailored rehabilitation, including physical therapy, occupational therapy, speech/language therapy, physical medicine, psychology/psychiatry, and social support. Patients suffering from moderate to severe brain injury can struggle long-term with multiple disabilities, including, but not limited to:
- Cognitive deficits, such as confusion, impulsiveness, memory loss and difficulty maintaining concentration;
- Speech/language deficits, including difficulty understanding the spoken word, difficulty speaking, slurred speech and difficulty reading and/or writing;
- Difficulties with interpretation of sensory input, such as touch, temperature or limb position;
- Partial or total vision loss, blurred vision, or other vision-related problems;
- Ringing in the ears, hearing loss, or increased sensitivity to sounds;
- Loss or diminished sense of smell or taste;
- Chronic pain;
- Sleep disorders;
- Appetite changes;
- Aggression; and
- Dependent behaviors.
TBI can also cause epilepsy, and increase the risk for such conditions as Alzheimer’s disease, Parkinson’s disease, and other age-related brain disorders. Very severe TBI can leave the patient in a coma or vegetative state, requiring years of nursing home care.
Even a mild TBI – classified as loss of consciousness or confusion/disorientation lasting less than 30 minutes – can have long-standing aftereffects. While MRI and CAT scans are often normal, the patient may experience headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration – among other symptoms – for weeks or even months after the injury. Repeated mild TBI occurring over months or years can cause cumulative neurological and cognitive deficits. If injuries are repeated over a short period of time (hours, days, or weeks), they can be catastrophic, even fatal.
Direct medical costs related to TBI, along with such indirect costs as lost productivity, totaled an estimated $60 billion in the United States in 2000, according to CDC data.
Treatment of more than 1 million children with sustained brain injuries annually requires special consideration. In the case of shaken babies, respiratory support and surgery to stop bleeding in the brain can save the child’s life. MRI and other diagnostic technologies may be used repeatedly to track progress, as well as to diagnose the initial damage.
Not only can children sustain similar long-term symptoms as adult traumatic brain injuries, but as the child grows and develops, parents and teachers may notice new problems. As students grow, they are expected to use their brain in new and different ways, so damage from an earlier injury may not become apparent until substantially later in the child’s life. Students thought to have a learning disability, emotional disturbance, or mental retardation may, in fact, be facing fallout from a previous TBI.
Shaken babies face other issues, as well. Those who survive are almost certain to have some sort of neurological or mental disability, such as cerebral palsy or mental retardation, which may not be apparent before age six. Damage to the retina of the eye can cause blindness, as well.
How Can I Tell if I Suffered A Traumatic Brain Injury?
Regardless of the severity of the injury, or whether medical attention is sought immediately or later, imaging tests are critical to help determine a specific diagnosis, prognosis and treatment plan.
Skull and neck X-rays are common to check for fractures and spinal instability. Various other scans help determine changes to both the structure and the function of the brain. Techniques that look at the structure of the brain are:
- CAT scan: The CAT scan uses X-rays to “slice” the brain radiographically into slabs. This method is particularly good at detecting fresh blood in and around the brain.
- MRI: Like the CAT scan, the MRI slices the brain into sections, but uses magnetic fields to do so. While it cannot detect fresh blood as effectively as a CAT scan, the MRI is far better at locating old hemorrhaged blood, called hemosiderin. It also provides more detail than the CAT scan, showing brain damage as small as 1-2mm in size.
- Diffusion Tensor Imaging (DTI): This type of MRI uses special software to view parts of the brain a normal MRI cannot. This new technology images natural damage to the white matter. It is a very impressive technology and will be impressive to jurors and others involved in TBI litigation.
- MRA (Magnetic Resonance Angiography): This technology allows doctors to view the carotid and vertebral arterial systems in the neck and brain without having to inject contrast dye into the patient’s bloodstream.
There are several diagnostic imaging technologies available that provide information about damage to the brain’s function. These include:
- Electroencephalogram (EEG): Wires attached to the patient’s scalp act like antenna to record the brain’s electrical activity. Changes in normal electrical activity can provide insight into brain damage.
- Positron Emission Tomography (PET) Scan: The brain uses glucose for energy. By labeling a glucose molecule with a radioactive “tag,” then inhaling radioactive glucose and placing the patient’s head under a large Geiger counter, doctors can identify abnormal areas of the brain which are under-utilizing glucose.
- Single Photon Emission Computed Tomography (SPECT) Scan: SPECT scanning is similar to PET scanning in that a radioactive chemical is administered intravenously to the patient, but the radioactive chemical remains in the bloodstream and does not enter the brain. As a result, the SPECT scan maps the brain’s vascular supply. Because damaged brain tissue normally shuts down its own blood supply, focal vascular defects on a SPECT scan are circumstantial evidence of brain damage.
- Magnetic Resonance Spectroscopy (MRS): This new tool, used in conjunction with MRI, detects the intra-cellular relationship of brain metabolites. While MRS is in its early stages, it holds great promise in the “objectification” of brain injury.
- Evoked Potentials: Each time a sensory system of the body – vision, hearing, touch – is stimulated, an electrical signal is generated in the brain. Using Evoked Potentials studies, these electrical signals can be detected with electrical wires on the scalp, showing any deficits that could indicate brain damage.
- Lumbar Puncture: A lumbar puncture – also known as a spinal tap – is used to analyze cerebrospinal fluid. Analysis of the fluid can help tell doctors, for example, if there is any bleeding in the brain and spinal cord areas.
What Does all of This Mean to Me?
People who suffer from traumatic brain injury need specialized legal representation to pursue their case. Brain injury litigation is very complex and unique. Getting fair compensation requires lawyers that are experienced, and familiar with the medical and legal issues involved.
If you believe that you or a loved one suffered a traumatic brain injury due to another person’s or business’s negligence, please contact us in Columbia, South Carolina, for a free consultation.