Traumatic Brain Injury Evaluation After an Accident

A traumatic brain injury is not benign. It interferes with the brain’s normal function, which has consequences such as lowered life expectancy and dementia. A mild traumatic brain injury with transient loss of consciousness, confusion, and disorientation is often just the beginning of a lifelong disease process.

Sports injuries have broadened our understanding of the effects of a TBI long after it occurred, as well as the cumulative consequences of multiple TBIs. 

A baffling aspect of traumatic brain injury is that symptoms may initially be hidden during the aftermath of an accident. That is why a complete diagnostic workup should be performed before filing a claim if a TBI is suspected. An experienced brain injury lawyer will explore the possibility of a TBI if evidence suggests it. Let’s look at the reasons that indicate a TBI, the diagnostic criteria used to prove it, and contradictory evidence that can cause a case to blow up. 

We are familiar with the consequences of a traumatic brain injury when the TBI is severe. But what happens when the client does not present with grave symptoms but those that could be perceived as routine after an accident? 

The head injury is often ignored as more prominent injuries are attended to. However, mild TBI may show itself in the following weeks, months, or years. Studies show that the severe aftermath of a TBI can result in life-altering circumstances and increase the risk of death. Some of the more alarming consequences are:

• Lowered mortality: People who suffer TBIs are likely to die sooner than those who did not have a traumatic brain injury. Studies suggest that a mild TBI can result in a death rate that is two and one-half times higher than usual. 
• Dementia: Those who suffer a traumatic brain injury are more likely to be afflicted with dementia. The incidence increases with multiple TBIs. For instance, a person who has a single traumatic brain injury will have a 24 percent greater chance of suffering from dementia. However, someone with multiple TBIs will have three times the risk of dementia in the future.
• Endocrine abnormalities: Damages due to the pituitary gland dysfunction following a head injury can result in thyroid gland problems. Such occurrences can result in cardiovascular disease, high cholesterol, cognitive dysfunction, and respiratory problems. 
• Memory issues: Problems with remembering are common. For the most part, short-term memory is affected more than remembering things that happened in the past. For instance, many people with moderate or severe traumatic brain injury have difficulty remembering the accident. This can pose legal problems since they cannot describe how and why the crash occurred. One predominant effect of TBI is the injured party having difficulty remembering appointments or what they must do daily. For this reason, using Post-its around the home or on a bulletin board helps. This gives the person a way to work past the effects of TBI on memory. 
• Sleep disorders: TBI patients frequently have problems with sleep. This is caused when the brain injury interferes with the function of the internal clock. Sleep disorders are three times higher in TBI populations. Approximately 60 percent of all traumatic brain injury patients have sleep disturbances. These problems often increase with age, and women have a higher risk of developing sleep problems. Some of the more common sleep disturbances are:
  • Difficulty falling and staying asleep
  • Narcolepsy is common, and the person may fall asleep anywhere at any time
  • Excessive daytime sleepiness
  • Restless leg syndrome
  • Sleepwalking
• Mood disorders: Mood swings are common after a traumatic brain injury. They are best described as an emotional rollercoaster where the person can be happy and cry. Doctors call this emotional lability. This occurs because the part of the brain that controls emotions is damaged. The brain injury patient may display emotions opposite to what one would expect. For example, they may laugh at a sad or severe event and cry at a happy one. Many times, this range of emotions occurs for no specific reason. This problem will gradually resolve in many patients as they return to a more normal affectation. Talking to a physician is necessary to get emotional lability under control. Sessions that involve the family are helpful and help them cope with the situation. Sometimes, medications are used. Family feedback and working with the individual help as they move through this period. 
• Anxiety: Brain-injured patients experience higher levels of anxiety. For the most part, many cannot explain why they feel this way; it just happens. Brain-injured patients often worry about failing to do a job or making mistakes, leading to higher anxiety. Crowds also can be a problem for them, and the incidence of panic attacks may increase. Decreasing the number of demands and slowing the pace of the person’s work may help dispel anxious feelings. 

The video below provides an overview of some key points to understanding a traumatic brain injury.

Beginning with the first interview, a lawyer must correlate prominent symptoms with a traumatic brain injury. Using a checklist to document this finding can be an enormous aid. It may be challenging to document symptomology by speaking solely with the injured party, and broadening the interview to include the family is best. 

Our investigators are dispatched to the accident site to check for evidence that supports a TBI accident. This can be found by examining the crash site and obtaining video surveillance data from traffic cameras and businesses nearby. Obtaining the helmet may be helpful if the injured person is a motorcyclist or cyclist. 

Witnesses provide tremendous information about how the person acted immediately after the crash. This recounting of their behavior or lack of consciousness may be better than that obtained by emergency responders and hospital employees. A 911 recording also provides descriptive evidence of the incident and the injured person. 

Other criteria that can be used are:

• CT scans: This is a common test done to record a TBI. It reveals skull fractures, brain swelling, or bleeding. CT scans are often read as usual when the TBI is classified as mild. It is unable to document a concussion. However, having a record of this test being ordered is essential since it documents the doctor’s suspicion of a TBI. It can show a hematoma, which is often a marker of a TBI.
• MRI: This test can show damage to the brain tissues and is ordered if a patient continues to have symptoms suggestive of a traumatic brain injury. The most sensitive form of MRI testing for this purpose is susceptibility-weighted imaging. This is capable of showing minor disturbances in the brain matter. For instance, it can detect iron, which may signify trace amounts of blood. This indicates that the individual suffered a brain bleed before the test. As newer types of MRI imaging become available, evidence of a TBI will be more precise. It is incumbent on the attorney to stay abreast of new types of MRIs, something experts can help with. 
• Functional MRIs (fMRI): This test is done while the TBI patient performs a task. They can show frontal lobe issues after an accident.
• Positron emission tomography: This test is also used to evaluate brain function.
• SPECT scan: Often used to support a presumptive diagnosis of a brain injury.
• History: Reviews of the person’s physical and social history can be used to build a strong case against defense arguments. For example, if the client has had prior TBIs, the defense may say that the current injury was not causing their symptoms. It is possible to argue that not only did the current accident cause a TBI and aggravated the prior injury, causing the person increased disability. 
• Work history: Talking to coworkers is one way of evaluating the traumatic brain injury client’s ability to perform their work. If there were problems in the past, this might be used against them by the defense.

Today, social media is used to communicate with friends and post pictures of activities. This allows social interaction even in a society where friends move frequently. However, it also allows a defense attorney to spy on a plaintiff. He or she can monitor a client’s posts and gain knowledge of activities not in line with the client’s claimed disabilities. Even if a client does not post such activities, the defense attorney can use facial recognition to single the client out. The lesson is that a client looks disingenuous, especially to a jury. While most clients do not claim disabilities that are untrue, TBI patients suffer due to the few who do. 

It is best to wait at least one year before initializing neuropsychological testing to understand the patient’s behavior in light of their injury. If this testing is done too early, the results will be provided with the caveat that subsequent testing may be needed to give a final evaluation. If the case is concluded too early and testing shows a decided problem after that, the fact that the client accepted the payoff will prevent them from collecting more in the future. 

You can be compensated for your financial damages if you’ve suffered a brain injury. Since TBI cases often result in high verdicts and are costly to fight, the defense will do everything possible to keep you from winning. Our firm does everything possible to ensure you receive the compensation you deserve. Call me at 707-564-1900 or (800) 404-5400 for free and friendly advice. We’ve helped the good people of Vallejo since 1982 in all kinds of car accidents, wrongful deaths, and truck crashes. See our past cases of Settlements and Verdicts.

^{Editor’s Note: updated [cha 8.22.23] Photo Attribution: Photo by Gustavo Fring from Pexels cd llo [cs 1662]}