TYPES OF BRAIN INJURIES

Concussion
A concussion is considered a mild traumatic brain injury and is the most common type of TBI. A concussion is often caused by a direct blow to the head but can also be caused by violent shaking of the head or force from a whiplash-type injury. These TBI’s usually do not show up on brain scans.

Second Impact Syndrome
This type of brain injury occurs when a person sustains a second trauma to the brain before the first trauma has fully healed. The second impact is more likely to cause serious injuries.

Contusion
A contusion is a bruise on the brain that is caused by a force to the head.

Closed Head Injury
A closed head injury occurs when the brain is injured but there is no penetration of the skull. Closed head injuries can be very serious because the brain swells but has no place to expand as it swells. This can lead to permanent brain damage and death.

Penetrating Injury
A penetrating brain injury is when there is a direct impact on the brain from an object such as a bullet or knife. This is an open head injury.

Diffuse Axonal Injury
A diffuse axonal brain injury is caused by rotation of the head or shaking. Rotational forces from a motor vehicle accident can cause a diffuse axonal brain injury.        

Coup-Contrecoup Injury
A coup-contrecoup brain injury occurs when there are injuries on opposite sides of the brain. This type of TBI typically occurs when force to the head is so great that it causes the brain to move and essentially crash into the opposite side of the skull. These injuries can result from a motor vehicle accident.

Abusive Head Trauma
Abusive head trauma is also known as Shaken Baby Syndrome. This brain injury occurs due to someone aggressively shaking a baby or child.

POST-CONCUSSION SYNDROME

A concussion, or mild traumatic brain injury, is a serious medical condition that can lead to permanent impairment and disability. A mild TBI can cause many complications, including the following:

• Headaches
• Confusion
• Lightheadedness
• Dizziness
• Blurred vision
• Tinnitus, or ringing in the ears
• Bad taste in mouth
• Fatigue or lethargy
• Sleep changes
• Mood changes, including becoming more emotional
• Behavioral changes
• Trouble concentrating
• Trouble paying attention

According to the CDC, some mild TBI symptoms appear right away, but others may not appear for hours or even days after the injury. The effect of a mild TBI is different for each person. It is not unusual, for example, to initially have headaches but then later start having trouble sleeping. Many of these problems are overlooked by healthcare providers. The CDC also notes that while these TBI’s are referred to as “mild” because they are not usually life-threatening, the effects of a mild TBI can be serious.

Most people experience a resolution of symptoms within a couple of weeks after the trauma occurs; however, many people do not. If symptoms last longer than one or two months, the person may be suffering from a condition known as Post-Concussion Syndrome (PCS).

PCS must be properly treated in order for recovery to occur. Treatment of PCS may include the following:

• Oculomotor Training, or vision therapy
• Neuro-Optometric Rehabilitation
• Vestibular Therapy, or balance therapy
• Physical Therapy
• Exertional Therapy
• Cognitive Behavioral Therapy
• Cognitive Rehabilitation Therapy
• Neuropsychology
• Occupational Therapy
• Psychiatry
• Meditation

For those suffering from PCS, a neurologist and/or psychiatrist will normally be necessary to provide treatment. In many cases, antidepressants and psychotherapy will be required.

TINNITUS

Over half of TBI patients will develop ringing in the ears. This sound can range from a hissing noise to a buzzing noise, but it is often the first sign of a prolonged brain injury. Tinnitus is usually a direct result of the trauma to the brain; however, it can also be caused by medications used to treat a TBI. It is common for people with tinnitus to also have hearing loss, but this is usually not noticed because of the ringing in the ear.

ANXIETY AND DEPRESSION

Anxiety and depression are common after a TBI. While some people experience anxiety and depression immediately following an injury, others do not develop symptoms until months or even years after the injury. Signs and symptoms include the following:

• Feeling hopeless
• Loss of interest in usual activities
• Feeling that you are a failure
• Difficulty concentrating
• Withdrawing from other people
• Always feeling tired
• Changes in appetite
• Changes in sleep pattern
• Suicidal ideation

Many people with mild TBI and PCS are functioning and therefore it can be difficult for others to understand what they are going through. It is not uncommon for a PCS patient to say things like, “I just don’t feel the same” or “I am just not the same way I was before the accident.” Even close family members and loved ones may not understand what the person is going through. In these situations, it is crucial that the proper psychological treatment is provided.

NEUROCOGNITIVE TESTING

Neurocognitive or neuropsychological tests are sometimes administered by healthcare providers to identify the effects of a TBI. These tests are designed to identify problems with learning, memory, concentration, and problem solving. As noted by the CDC, even if an injury does not show up on these tests, an individual may still have a mild TBI.

Neurocognitive tests typically last several hours. These tests are called “standardized,” which means they are given to everyone in the same way. After the test is completed, the person’s performance on the test is then compared to the performance of other people. Two of the most common neurocognitive tests are the MMSE (Mini-Mental State Examination) and the MoCA (Montreal Cognitive Assessment).

TREATMENT OF MODERATE TO SEVERE TBI’S

Moderate and severe TBI’s can be life threatening and require immediate and prolonged treatment. Such treatment often includes the following:

• Surgery
  • Remove hematoma or blood clot
  • Remove damaged brain tissue
  • Repair skull fractures
  • Relieve pressure in the skull

• Medication
  • Anticoagulants to prevent blood clots
  • Anticonvulsants to prevent seizures
  • Muscle relaxants to prevent muscle spasms
  • Antidepressants and/or anti-anxiety medications

• Rehabilitation
• Physical Therapy
• Occupational Therapy
• Speech Therapy

• • Cognitive Therapy
  • Psychological Therapy
  • Vocational Counseling

DAMAGES FOR TRAUMATIC BRAIN INJURIES

A person suffering from a TBI may have a claim for damages regardless of the underlying mechanism of injury. Claims for mild TBI and PCS can be very challenging, as defendants vigorously dispute these injuries and do everything possible to discredit those suffering from these injuries. If you have a TBI or someone you know has a TBI, you will need an attorney who has experience handling these types of cases and can ensure that the proper care and treatment is provided.

In a TBI claim, the following damages can be awarded:

Economic Losses

Economic damages are ascertainable monetary amounts, including lost wages and medical bills. A person suffering from a TBI often will not be able to return to work and therefore may be entitled to the loss of future wage-earning capacity for the remainder of the anticipated life expectancy. In addition, TBI victims usually require medical treatment for the rest of their lives. To calculate the amount that this long-term care will cost, our firm may retain a specialist to prepare what is known as a “life care plan,” which is a plan that sets out medical and medically related care that will be needed over the remainder of the injured person’s life due to the TBI.

Non-Economic Losses

Non-economic damages include items such as emotional distress, mental pain and suffering, physical pain and suffering, disfigurement, and humiliation. A TBI is a life altering injury, and the law therefore permits a person with a TBI to recover for more than just medical bills and lost wages.

Wrongful Death Damages

A TBI often results in death. In such a case, the deceased’s family members, or wrongful death beneficiaries, may be entitled to recover the medical bills as well as the funeral and burial costs. The deceased’s loved ones can also recover for their own damages due to the loss of love and society of the deceased person.

Loss of Consortium

A loss of consortium claim is a claim that seeks damages for the spouse of the injured party. When a married person sustains a TBI, the person’s spouse is often required to take on the role of the primary caregiver. Many spouses have to bathe their spouse, help the spouse use the restroom, groom the spouse, drive the spouse who can no longer operate a vehicle, take over duties that the spouse used to perform, and countless other examples. When this happens, the spouse is entitled to recover damages.

Punitive Damages

Punitive damages are damages that are meant to punish the wrongdoer as opposed to compensating the victim. Punitive damages are available only if it is proven by clear and convincing evidence that the defendant engaged in conduct with malice, oppression, or fraud.

TIME LIMITS FOR FILING CLAIMS FOR TBI

In California, the statute of limitations for filing most claims is two (2) years from the date of the injury. If, however, the claim is against a state or local governmental entity, the deadline to provide notice of your claim may be as little as six (6) months. For this reason, if you believe you or someone close to you may have a claim for damages, you should contact an experienced attorney as soon as possible.