Proving Traumatic
Brain Injury
An array of psychological, physical, and mental tests are available which can
determine the location, extent and severity of impairment/deficits within each
brain function caused by a head injury. Neuropsychological testing, clinical
physiologists, PET scans, SPECT scans and MRIs also provide information about a
brain injury.
Those who suffer skull fractures, loss of consciousness and/or coma typically
are diagnosed as severe injuries, with obvious physical impairments that are
easily verified. Because they have suffered objective physical injuries, their
resulting impairments are readily accepted as having been caused by the initial
impact. Other cases present more difficult proof issues, since symptoms may not
be as readily apparent to a jury made up of people who were not familiar with a
plaintiff’s normal functioning prior to an accident. An attorney must have a
thorough understanding of the symptoms of TBI in order to adequately present a
case for damages to the jury.
Some of the physical consequences that may occur after a brain injury include
decreased muscle control, paralysis, weakness, seizures, sensory losses, and
difficulty speaking or swallowing. Lost motor control or weakness of one arm or
leg or on one side of the body is known as hemiparesis. Poor balance, decreased
endurance, loss of the ability to plan movements of arms, legs and poor
coordination are evident. Seizures can occur immediately or may be delayed
until months or even years after the initial trauma. A seizure is a burst of
abnormal electrical energy in the brain. In generalized seizures, or major motor
seizures, the entire body stiffens. Loss of consciousness, irregular breathing,
and loss of bowel and bladder accompany severe shaking. After regaining
consciousness, the patient reports soreness and confusion. A second category of
seizures are known as focal motor or partial seizures which present as jerking
movements or twitching. Consciousness remains intact and often is viewed as a
loss of concentration. Often the patient does not know that a seizure has taken
place.
Following TBI, sight, sound, taste, touch and smell can suffer decreased or
increased sensitivity, or a complete loss. Loss of sensation to parts of the
body and hypersensitivity are also common. Double vision, loss of depth
perception, and an inability to see on one side of the body can occur. Loss of
the inability to know where arms and legs are in relationship to the body also
takes place.
Fatigue is extremely common in the early stages following injury. In many cases
the fatigue is profound, and staying alert and awake for these patients is
difficult. This can easily be confused with being unmotivated because these
patients have difficulty paying attention and are sleepy. Speech disorders
follow damage to the cranial nerve which enervates the face. Dysarthria,
difficulty in pronouncing words, characterized by slurred or slow speech or loss
of the ability to vocalize, results from weak muscles or reduced coordination of
the muscles required to produce speech. A closely related condition, dysphagia,
the inability to swallow and chew properly, can be readily observed when a
patient extends his/her neck or engages in some accommodating movement when
swallowing. Reports of choking or the need to soften food with water before
swallowing are significant.
Sleep disorders are another area of inquiry. Total reversals of sleep patterns,
the need for multiple naps and rest periods and loss of bowel and bladder
control are reported. Neurologic damage readily disrupts how a person thinks and
processes information. Memory, attention, organization, planning and perception
are functions disrupted by TBI. Attention and concentration is something most of
us do well. We pay attention and focus on a specific task and block out
distractions both internal and external. Survivors of TBI quickly change
subjects and have difficulty following through an idea or a sequence to
completion. The slightest distraction causes a complete loss of concentration
and results in confusion. Without attention and concentration, learning cannot
occur.
Significant confusion following a head injury is so common that the primary
medical inquiry is to establish if the patient is oriented. Not knowing the day,
week, year, where they are or what happened results in the patient asking
searching questions. Coping with confusion is extremely frustrating and leads to
more confusion. As a defense mechanism to bring rationality to their existence,
many patients will develop their own explanation or history, integrating some
accurate information, into a fabric of reality and fantasy. Confabulation is not
coping with reality, but it is more closely associated with denial and is a
defense mechanism. Survivors have difficulty planning which is known as impaired
executive function. Planning requires good memory, learning, judgment, attention
and organizational skills. Difficulty in following a logical progression or
focusing or getting stuck on one step, stage or activity raises frustrations.
Dealing with abstract concepts as literal facts is additionally confusing.
The most significant hurdle after injury is often memory loss and impairment.
The mind’s capacity to receive, store and retrieve information is affected.
Loss of short-term memory is more common than the loss of recall for older
information. This should not be confused with retrograde amnesia, which is the
inability to recall events before injury. Anterograde amnesia is the inability
to recall events that have occurred since injury.
Impaired communication skills, such as aphasia, the inability to understand or
recall the simplest words, is caused by brain cell damage, not by physical
inability to speak. Survivors who have difficulty understanding are diagnosed
with receptive aphasia. Expressive aphasia is the diagnosis for those having
difficulty remembering words, naming objects or expressing ideas.
Impaired judgment occurs when abstract thinking is impaired. Being stimulus
bound is when the brain only recognizes and reacts to objects and events in the
immediate environment. Applying a task to a similar but different situation
cannot be accomplished. Difficulty in interpreting the actions or inaction or
others is common. Those who show concern and attention can be viewed as being
angry toward the survivor.
Frontal lobe injuries can be interpreted as causing dullness because this area
of the brain controls impulses, motivation and initiation. These survivors need
to be reminded and prompted in simple tasks, such as daily care and living tasks.
Regular encouragement and visual cues are helpful in prompting initiation.
In addition to physical consequences of TBI, the ability to understand feelings
and the ability to control emotions are impacted. A whole range of behavioral
symptoms occur with TBI: agitation, depression, frustration, rapid changes in
emotion and severe mood changes, insensitivity to others, self-centeredness,
rage tantrums, poor impulse control, loss of inhibition, decreased libido,
inappropriate sexual expression and loss of self-esteem. Pre-existing conditions
may be amplified following TBI.
Survivors suffering moderate to severe injuries will have hospital and
rehabilitation care from a wide range of professionals. Knowing the role of
these providers is important to appreciating the significance and magnitude of
TBI and in formulating a courtroom presentation that explains the breadth of
disability a survivor must endure.
In cases involving Traumatic Brain Injury, it is essential that measures be
taken promptly to preserve evidence, prove the nature and extent of your
injuries, and to enable expert medical witnesses to support the cause of your
injuries. If you or a loved one has suffered what you believe may be a traumatic
brain injury from an accident, call Estey & Bomberger, LLP now at 800-672-1036
or CLICK HERE TO
SUBMIT A SIMPLE CASE FORM. Don’t delay! You may have a valid claim and be
entitled to compensation
for your injuries, but a lawsuit must be filed before the statute of limitations expires.
<< back
|
