Traumatic Brain Injury (TBI) is extraordinarily common in California. According to the California Department of Public Health, California emergency rooms treated 142,139 people for traumatic brain injuries in 2007. Of that, 29,354 were hospitalized, 7 percent of which died. The two leading causes for patients visiting the hospital with a traumatic brain injury are slip and falls and car accidents. A blow to the head or violent shaking of the brain within the skull can lead to a brain injury, both of which typically happen in slip and falls and car accidents. These brain injuries can range from mild to severe. The most common type of brain injury in Orange County is a mild brain injury, also known as a concussion. Calling a brain injury “mild” is actually a misnomer though because they can be devastating for people and should be taken seriously. If you have recently sustained a brain injury due to someone else’s negligence, you may be entitled to compensation. Contact our Orange County traumatic brain injury attorneys at the Crockett Law Group to learn about how we can help you maximize your settlement. Call (800) 900-9393 for a free consultation with an Orange County personal injury attorney.
Table of Contents
What Is a Traumatic Brain Injury?
A traumatic brain injury (TBI) is defined by the CDC as a disruption in normal brain function as a result of a bump, blow, or jolt to the head. The severity of a TBI ranges from mild, moderate, to severe. A mild TBI is also known as a concussion.How Do You Prove a Brain Injury?
Diagnosing a traumatic brain injury can be difficult because oftentimes the person does not show signs of physical injury, so they are often overlooked. A neurological exam is usually the first step, though. There are primarily two guidelines that are used, one published by the Department of Defense, and the other is called the Glasgow Coma Scale (GCS). If a TBI is suspected based on the results of these neurological exams, then brain imaging tests may be warranted.Department of Defense Guidelines
The Department of Defense guidelines look at the duration of loss of consciousness (blacking out), post-traumatic amnesia (memory loss immediately following an injury), and altered mental status (confused or disoriented). Mild TBI/Concussion Mild concussion symptoms include:- Loss of consciousness of fewer than 30 minutes; or
- Post-traumatic amnesia lasting less than 24 hours; or
- Altered mental status less than 24 hours. (Structural brain imaging is normal)
- Loss of consciousness for more than 30 minutes but less than 24 hours; or
- Post-traumatic amnesia lasting more than 24 hours but less than 7 days; or
- Altered mental status lasting more than 24 hours. (Structural brain imaging may be normal or abnormal)
- Loss of consciousness for more than 24 hours; or
- Post-traumatic amnesia lasting more than 7 days; or
- Altered mental status lasting more than 24 hours. (Structural brain imaging may be normal or abnormal)
Glasgow Coma Scale (GCS)
The Glasgow Coma Scale is a 15-point test that assesses patients based on their ability to move their eyes and limbs and follow directions. Each of the three categories is given an individual score that is then added up all together: Eye Response (4)- No eye opening
- Eye opening to pain
- Eye opening to sound
- Eyes open spontaneously
- No verbal response
- Incomprehensible sounds
- Inappropriate words
- Confused
- Orientated
- No motor response
- Abnormal extension to pain
- Abnormal flexion to pain
- Withdrawal from pain
- Localizing pain
- Obeys commands
- Mild TBI/Concussion: GCS score of 13-15
- Mild TBI: GCS score of 9-12
- Severe TBI: GCS score of 3-8
Neuroimaging Tests
Neuroimaging tests may be warranted if an emergency room patient presents with symptoms of a TBI based on the results of a neurological exam. There are primarily two neuroimaging tests used to diagnose a TBI: (1) CT Scans, and (2) MRI.CT Scans
Computerized tomography (CT) scans are most commonly used by emergency room physicians who suspect a traumatic brain injury. A CT scanner uses a rotating X-ray machine to obtain images of brain tissue and brain structures. The scanners are capable of detecting blood clots (hematomas), brain bleed (hemorrhage), bruised brain tissue (contusion), and skull fractures. However, a CT scan will usually produce normal results for somebody with a mild TBI, such as a concussion.MRI
Magnetic resonance imaging (MRI) is most commonly used when symptoms persist following the acute period of a TBI. An MRI machine uses a magnetic field and radio waves to create images of your brain. These machines are particularly good at detecting injury to nerve fibers (diffuse axonal injury) according to the Journal of Affective Disorders. MRIs are also useful diagnostic tools as far as diagnosing a cerebral microbleed (microhemorrhage) and bruised brain tissue (contusion). It’s important to note that neuroimaging tests, such as CT scans and MRI, oftentimes show “normal” results. However, “normal” does not mean a person did not sustain a TBI. These tests typically only detect large abnormalities and fail to detect other signs of brain injury.What Are the Different Types of Brain Injuries?
The term “brain injury” can be vague because there are so many different types, and each type is associated with a different outcome. With that being said, brain injuries typically fall within one of three categories: (1) open head injury; (2) closed head injury; and (3) skull fracture.Open Head Injury
An open head injury, also known as a penetrating brain injury, occurs when an object pierces the skull and enters the brain tissue.Closed Head Injury
A closed head injury is a brain injury caused by an external impact that moves the brain within the skull but does not break the skull. A concussion is one type of closed head injury and the most common type we see from accidents in Orange County, CA.Concussion
A concussion is a brain injury that results in a temporary loss of normal brain function. Note, though, that a person doesn’t have to lose consciousness to sustain a concussion. A concussion is caused by either a blow to the head or a violent shaking of the head. Imaging studies, such as CT scans and MRIs, do not help diagnose a concussion; the diagnosis is clinical in nature.Epidural Hematoma (EDH)
An epidural hematoma refers to bleeding between the inside of the skull and the outer covering of the brain (called the dura). The leaking blood forms a hematoma (mass of blood) that puts pressure on the brain tissue.Subdural Hematoma (SDH)
A subdural hematoma refers to bleeding between the outer covering of the brain (dura) and the surface of the brain. The leaking blood forms a hematoma that puts pressure on the brain tissue.Intracerebral Hemorrhage (ICH)
An intracerebral hemorrhage refers to bleeding that occurs within the brain tissue.Cerebral Contusion
A cerebral contusion refers to a bruise on the brain’s surface, which causes bleeding and swelling inside the brain. In other words, a brain contusion often results in an intracerebral hemorrhage.Diffuse Axonal Injury (DAI)
A diffuse axonal injury refers to widespread damage of nerve axons throughout the brain, which disrupts nerve communication. Car accidents are the most common cause of DAI.Skull Fracture
A skull fracture refers to a break in the skull bone. There are 3 types of skull fracture that are particularly relevant to accidents:Linear Skull Fracture
A linear skull fracture refers to a break in the skull with a single fracture line. This is the most common type of skull fracture.Depressed Skull Fracture
This refers to a fracture in the skull with pieces of bone being pushed inwards towards the brain.Basilar Skull Fracture
A basilar fracture is located at the base of the skull. This is the most serious type of skull fracture.Can You Get Brain Damage From a Car Accident?
You can absolutely get brain damage from a car accident. In fact, the CDC says that car accidents are the second leading cause of all TBI hospitalizations, only second behind falls. There are several other causes of brain injury as well, such as motorcycle crashes, bicycle crashes, and pedestrian accidents. As for car accidents, brain damage can happen in one of two ways: either from a direct blow to the head or from a violent movement of the head. Let’s take a look at both ways.Coup-Contrecoup Injuries
A car crash can cause an occupant’s head to strike an object (e.g., dashboard, roof, steering wheel, or window) or an object to strike an occupant’s head (airbag, glass, or metal sheared from the car). This area of direct impact is called a “coup” injury. If the brain subsequently moves to the opposite side and strikes the skull again, it’s called a “contrecoup” injury. Coup-contrecoup injuries are responsible for every type of brain injury there is, including open head injuries and skull fractures.Acceleration/Deceleration Injuries
A car crash can cause an occupant’s head to jerk backward and then forwards where it abruptly stops, meanwhile their brain still has forward momentum and winds up striking the inside of their skull. Acceleration/deceleration injuries are responsible for concussions, brain contusions, hemorrhages, and diffuse axonal injuries.What Are Brain Damage Symptoms?
Symptoms of a brain injury might be noticed right away, or they might not appear at all until several days or weeks later. Sometimes people don’t even realize they are experiencing symptoms of a TBI until others bring it to their attention. TBI symptoms fall into one of these three categories: (1) cognitive, (2) emotional, and (3) physical.Cognitive Symptoms
Decreased attention and concentration, difficulty processing and understanding information, language and communication problems, planning and organizing problems, problems learning and remembering new information, and problems with reasoning/problem solving/judgment.Emotional Symptoms
Anger, anxiety or nervousness, depression, impulsiveness, mood swings, and irritability.Physical Symptoms
Blurry vision, diminished sense of smell (anosmia), dizzy, fatigued, headaches, lethargy, nauseous, poor balance, poor coordination, reduced sense of taste, ringing in the ears (tinnitus), seizure, sensitivity to light (photophobia), sensitivity to sound (phonophobia), sleep disturbance, and vomiting. These symptoms are a part of the normal recovery process for a brain injury. They can be expected to resolve within about 3 to 6 months for a majority of people.Can TBI Symptoms Get Worse Over Time?
TBI symptoms can get worse over time, but how long those symptoms persist depends on the type of TBI you sustain. As you can probably imagine, people with a moderate or severe TBI can generally expect symptoms for a longer period of time than people with a mild TBI (i.e., a concussion).Post-Concussion Syndrome
TBI symptoms do resolve fairly quickly for a majority of people who sustain a mild traumatic brain injury. However, for about 20% of people they don’t. When TBI symptoms continue to persist for months or years after an injury, it’s referred to as a post-concussion syndrome. According to the VA, a certain percentage of people with head injuries can be expected to experience the following symptoms of post-concussion syndrome at some point in their recovery:- Sleep difficulties: 80 percent
- Poor concentration: 71 percent
- Irritability: 66 percent
- Fatigue: 65 percent
- Depression: 63 percent
- Memory problems: 59 percent
- Headaches: 59 percent
- Anxiety: 58 percent
- Trouble thinking: 57 percent
- Dizziness: 52 percent
- Blurry or double vision: 45 percent
- Sensitivity to bright light: 40 percent