As an attorney representing car accident victims with traumatic brain injury, I often tell people that many brain injuries, including concussions, will heal and that many people can definitely go on to lead normal, productive lives.
But…
Some can’t. Unfortunately, there’s an unlucky percentage of people with a brain injury and a concussion after a car accident whose symptoms don’t resolve and who don’t get better. This creates tremendous problems for them functioning in society. Closely connected with this is the problem of how many of these people with concussion injuries are treated by many doctors unfamiliar with TBI. I’ve previously written about the societal cost of traumatic brain injury when TBI and concussion are not properly diagnosed.
The key difference between an injury to the brain, and an injury to the body is that brain injury is a process, not an event. Dr. Brent Masel makes this point quite clearly in his excellent article on traumatic brain injury. In fact, brain injury symptoms can often, get worse, intensify, change and evolve over time into new symptoms for the unlucky person with a brain injury or concussion.
A doctor quoted in a recent article on American Medical News: More brain injury awareness needed to curb concussions, CDC says, makes an important point about the people who do get better – and those who do not. This echoes my point above about the very significant minority of people who suffer head injuries and who do not get better. Instead they have lingering symptoms. According to Robert Cantu, MD, a clinical professor of neurology and neurosurgery at Boston University School of Medicine:
“Concussion symptoms, including difficulty thinking clearly, dizziness and irritability, often resolve within a week or two, research shows. But in 20% of the cases, symptoms last for months or years, which can negatively affect people’s performance in school or at work.“
Dr. Cantu is co-director of the Center for the Study of Traumatic Encephalopathy, a joint venture of Boston University School of Medicine and the Sports Legacy Institute.
“To call [a concussion] a mild injury is very inappropriate,” Cantu said.
As a lawyer who represents people injured in automobile accidents, I’ve obviously seen my share of serious brain injuries. And my own experience reflects the medical literature.
Many of my clients who suffer altered mental status, including loss of consciousness at the scene of these car accidents and who quite clearly have suffered a concussion, do go on to make a great medical recovery – at least for their brains. When I file a lawsuit for them, I often won’t even claim the brain injury, because it fully resolved within weeks or a few months after the car accident.
But there is a group, about 20% of the concussion injury victims that both myself and the other lawyers here see, whose brain injury problems don’t resolve (note: CDC data now shows that 75 percent of all traumatic brain injuries are concussions).
Each year in the U.S., 1.7 million people will sustain a brain injury. And auto accidents are the second-leading cause of traumatic brain injury, according to the Brain Injury Association of America.
I’ve written extensively about brain injury and concussions in sports, and the probability of subsequent concussions if a player’s symptoms are mistakenly dismissed as “getting his bell rung,” and he returns to the game too soon.
Although efforts have been made to improve prevention and early treatment of these injuries, a new CDC report says such measures don’t go far enough. The report was posted online July 12 in the CDC’s Morbidity and Mortality Weekly Report.
The agency is advocating that TBIs, including concussions, should be considered a serious public health problem.
It is also calling for improvements to brain injury surveillance systems that report national and state TBI data. Those changes would help researchers and others understand the epidemiology and long-term outcomes of such brain injuries, according to the article on American Medical News.
As I’ve said before, we have a long way to go in our fight against traumatic brain injury. That starts with medical professionals and brain injury lawyers both learning to be better equipped to protect people with TBI after a car accident.
Named a “Leader in the Law” and “Lawyer of the Year” by Michigan’s largest legal newspaper for his record-breaking auto accident verdicts, settlements and advocacy work in preventing wrecks, Steven Gursten heads Michigan Auto Law—a firm dedicated to serious motor vehicle accident injury cases and wrongful death lawsuits.
5 Comments
Cathy Turner
"IF ONLY". Working in the med field as mgr of The Edu Drpartment, I was told of being articulate. Beyond my desk were duties of teaching, counseling, lecturing, Arthur, and teaching customer service and working with the mayors office to do tours from dignitaries world wide. An auto accident in 2001 change everything. All internal injuries, which a pain pump is in the process of helping. Chronic Pain, TBI, and the rest of the alphabet! Sometimes I wish someone would tell me if I have moderate or severe... Since its been 12 years. I can take the pain, and I can take many things that my body goes through. What I struggle deeply with is the ability to simply think. I struggle enough that living is not something that I'm thankful for. No, I am not suicidal. That is not option. But what is life when you really don't know what's going on.? Some days you're more intelligent and others, you are dumber than rocks. Not only are you dumber than rocks, but you have lost every relationship just about. You're alone and isolated and it's not because you don't want to see people, it's because everyone is too busy. In my case I look just fine. I am a picture of health. Inside my body is a completely different story. Inside my brain is a very different story. I've learned to wear a mask. Because you are not believed by the medical field nor your friends nor are your family. So what do you do? You protect yourself and you wear a mask. Sometimes it's so wearisome to wake up and wonder what day of the month it is and what day it is and did you just wake up from a nap or did you wake up in the morning. And if you mention something in passing, you get the same old answer "I know what you mean, I go to the kitchen and then I can't remember what I'm there for all the time ". I would love to do that , I would love to go into a room and not figure out what I was therefore. But when you have to do that every time you go to a room and every time you have no clue what, when, why or how many. I want to ask those people, "do you have to write yourself a note and remind yourself who you are, what your name is, that you're married or not married, that your parents are alive or not alive, and where your husband is or isn't,. Not occasionally, but daily and sometimes more than daily. Sometimes every hour I'm asking what day is it, what time is it, ... So far today I've only had to do it about three times. Unfortunately, I still got confused and I had this as Thursday. So pills are messed up, and routines are all mixed up, and now I'm going to relive Thursday again. If it happened occasionally that would be fine. This is all the time. That is what it's hard, is when there's something wrong and no one believes you. No one has the time to stop to tell you things to tell you over and over, without making you look dumb or dumber. Condescending is so condescending! As I'm getting better, I would like to be an advocate for those who struggle with TBI. I have just won a plaque from America's Who's Who. And all I do is cry because I have no clue who I am. Where do I fit, it's a hopeless feeling but my energy is going to go into others so that they never have to feel the depths of hell of being completely alone and no one caring. Maybe people cared, but it was not the caring that gave me what I really needed. My doctors had me read the research to help me get out of denial. I read them but I knew I would stand-alone. My husband did all he could but he was playing two hats, And I felt sorry for him because he had no one to talk to. So I wore my mask even around him. He knew enough, he saw enough, but just now he's beginning to hear the story. The dream I had of our family being close has shattered along with many other dreams. Life goes on, hope is there, and helping others is what gives your heart the joy that it's missing. I am on linked in, and if there is anything I can do please let me know. Thanks.
Rachelle
Wow you said so articulately what so many of us go through. Thank you for putting that in words!
Anthony Castelli
I', looking for research that a one time concussive event with no brain bleed can be in that 20% Steve do you have a few cites from medical authorities
jc
One of the things I look for in traumatic brain injury is diffuse axonal injury (DAI). This occurs because during head trauma the white matter travels at a different speed then the gray matter causing neural axons to break. Obviously this causes thinking areas of the brain to become disconnected causing problems with learning and memory. An MRI brain can show this on gradient echo images. What it shows are tiny areas of hemorrhage at the gray/white junctions. Obviously, the more areas of hemorrhage you have, the more DAI you have and the worse the prognosis.
Paula West
My 22 year old grandson had a car accident 4 years ago when he was 18. He suffered head trauma and actually died but they brought him back to life. He was in a coma for several days and when he was released from the hospital it seemed like the biggest problem he had was memory loss. Since then, he has become delusional, paranoid, confused, violent and has been in and out of jail and prison. We don't know what to do to help him! We are so desperate for help! Can anyone offer any advice?
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