FAQ on Brain Injury

Serving Miami, Florida and Nationwide

FIGHTING FOR THE SAFETY OF YOU AND YOUR FAMILY

At Hickey Law Firm, P.A., we find that many individuals seeking information on traumatic brain injury cases have similar questions. For that reason, we have assembled this list of frequently asked questions so that people looking for information on filing a claim can use it as a resource.

If you are seeking legal counsel in the state of Florida for a brain injury, a Miami injury attorney from our firm can review your case and help determine your claim eligibility. Whether you have additional questions that have not been addressed below or you would like to schedule a free consultation, we invite you to contact our law office today. We represent people from all over the world against cruise lines and others. If you experience any brain injury symptoms or brain damage symptoms following a head injury, first seek medical attention, and then contact an experienced Miami and Fort Lauderdale injury attorney to learn about your legal rights by calling (855) 375-3727 today.

What Are Some Common Causes of Brain Injury?
Are There Different Types of Brain Injury?
What Are Some Symptoms of Brain Injury?
What Does the U.S Government Say?
What Compensation Am I Eligible for If I Have Been Injured?
Can I File a Claim on Behalf of a Loved One?
Do I Need a Lawyer?

What Are Some Common Causes of Brain Injury?

Brain injuries can be caused by a multitude of factors. Any sudden trauma to the head can result in a brain injury if it interrupts the normal functioning of the brain. According to the United States Centers for Disease Control, accidents involving falls account for the majority of brain injuries in the United States. Motor vehicle accidents and accidents involving sudden head trauma (from falling objects or collisions) account for roughly the same number of brain injuries annually, ranking closely behind falls. Rail accidents, defective products and medical malpractice can also result in potentially catastrophic brain injuries. Miami residents should make note that cruise ship accidents and cruise ship assaults can result in head trauma as well.

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Are There Different Types of Brain Injury?

Brain injuries can be categorized as mild, moderate or severe. Head injuries, which of course can cause brain injuries, are either closed head injuries or open head injuries. Closed head injuries occur when a trauma to the skull results in the brain coming into contact with the inside of the cranium. Such contact can result in bruising, swelling and internal bleeding within the skull.

An open head injury occurs when the skull is fractured or pierced in any way and foreign material or bone matter contacts the brain directly. Open head injuries can pose a significant risk to the victim, as there may be blood loss and the potential for bacterial infection. If you or a loved one has suffered a brain injury, it is imperative that you be in close contact with your healthcare provider to ensure you are receiving the care you need.

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What Are Some Symptoms of Brain Injury?

Though each brain injury is different, even so-called “mild” brain injuries can result in nausea and vomiting, severe headaches, convulsions and seizures from brain damage, drowsiness, blurred vision, slurred speech, weakness and numbness in the hands and feet. If you or someone you love has suffered a head trauma, even one you believed to be minor, and is experiencing any of these symptoms, seek medical attention as soon as possible. Suffering a brain injury can have severe consequences, and it is important to seek prompt medical care.

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What Does the U.S Government Say?

The National Institutes of Health (NIH) is a division of the United States Department of Health and Human Services. The NIH has created a National Institute of Neurological Disorders and Strokes (NINDS). NINDS, among other things, promotes research into and disseminates information on Neurological disorders including traumatic brain injury. According to NINDS:

  • Every year, millions of people in the U.S. sustain head and brain injuries. More than half are bad enough that people must go to the hospital. The worst injuries can lead to permanent brain damage or death.
  • Half of all TBIs (traumatic brain injury) are due to motor vehicle accidents. Military personnel are also at risk. Symptoms of a TBI may not appear until days or weeks following the injury. Serious traumatic brain injuries need emergency treatment.
  • Treatment and outcome depend on the injury. TBI can cause a wide range of changes effecting thinking, sensation, language or emotions. TBI can be associated with post-traumatic stress disorder. People with severe injuries usually need rehabilitation.

The NINDS website can be found at www.ninds.nih.gov. Under the NINDS traumatic brain injury information page, NINDS provides information and answers the following questions:

  • What is traumatic brain injury?
  • Is there any treatment?
  • What is the prognosis?
  • What research is being done?
  • Clinical trials
  • Organizations
  • Related NINDS publications and information
  • Publicaciones and espaňol
  • Additional resources from MEDLINEPlus

According to the NINDS information page:

Traumatic brain injury (TBI), also called acquired brain injury or simply head injury, occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently hits an object, or when an object pierces the skull and enters brain tissue. Symptoms of a TBI can be mild, moderate or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headaches, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. A person with moderate to severe TBI may show these symptoms but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures and inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness or agitation.

Treatment

NINDS admits that “little can be done to reverse the initial brain damage caused by trauma…” Initial treatment options include inferring proper oxygen supply to the brain and rest of the body, maintaining adequate blood flow and controlling blood pressure. Some severely head injured patients will need surgery to remove or prepare hematomas (ruptured blood vessels) or contusions (bruised brain tissue). According to NINDS “some common disabilities include problems with cognition (thinking, memory and reasoning), sensory processing (sight, hearing, touch, taste, smell) communication (expression and understanding) and behavioral or mental health (depression, anxiety, personality changes, aggression, acting out, and social inappropriateness).

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What Compensation Am I Eligible for If I Have Been Injured?

If you have suffered a brain injury as a result of another party’s negligence, you can file a personal injury claim against the liable party for damages. Depending on the circumstances of your injury, you may be able to obtain financial compensation. Serving Greater Miami, Florida, and the entire nation and world (for suits filed in Florida), a brain injury lawyer from Hickey Law Firm, P.A. can help you obtain the compensation you deserve.

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Can I File a Claim on Behalf of a Loved One?

It may be possible to file a claim on behalf of a loved one if he or she was catastrophically injured and is no longer able to care for him or herself. In such instances, you may be eligible to file for financial compensation to cover a lifetime of medical costs and living expenses as well as for loss of future wages and pain and suffering. If someone you love was killed as a result of a severe brain injury or trauma, you may be able to file a wrongful death claim against the liable party. In such cases, the plaintiff can typically obtain compensation for medical costs, funerary costs, loss of income in the event the loved one contributed to the household, pain and suffering, and loss of companionship.

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Do I Need a Lawyer?

Yes, you need a lawyer. The defendant will have a lawyer. The defendant will have a lawyer who is experienced and who will do whatever he or she can to get your case dismissed. If the defendant and the defense attorneys cannot get your case dismissed, they will try to trick the jury into believing either that the defendant did not do anything wrong to cause or contribute to the cause of the accident of incident or that you are not injured seriously.

 

The defendants’ lawyers have neuropsychologists whom they use on a regular basis. These psychologists perform tests that are subject to interpretation. They always testify that there is no traumatic brain injury.

Traumatic brain injury is, by definition, injury to the brain caused by an accident. injury to the brain caused by an accident. This can be caused either by a closed-head trauma, that is force or accident, or an open-head trauma or force or accident. A closed-head trauma is where your head strikes an object or the ground or a windshield, for example, or where the head gets shaken up or moved back and forth quickly like in a car accident when “whiplash” is caused. This actually can result in a very serious injury. The brain actually moves within the skull. If you hit your head hard enough against an object or if your head is moved forward and then backwards fast enough, your brain will come into contact with the inside of the skull. This is called a cou contra-cou injury. The brain actually hits against one side inside the skull and then moves back or reverberates and hits the other side of the skull.

The open-head trauma is where the skull is actually pierced or broken. Trauma can result not only from the cou contra-cou effect, which is the brain hitting the inside of the skull, but also from fragments of the skull becoming embedded in the dura or the brain itself.

The defendant’s insurance company will spend whatever it takes and their lawyers will do whatever it takes to prevent you from obtaining compensation. The defendant would rather spend money on their lawyers than spend money to prevent accidents and to ensure the safety and security of you and your family.

X-rays, CT scans and MRIs are not always good tests.

The standard of care of any hospital emergency room when you show up at the emergency room with a head trauma is to perform a CT scan. “CT” stands for computerized demographic imaging. A CT scan is a series of x-rays that are different slices or views of the brain.

MRIs also can be ordered. However, MRIs are more expensive and a CT scan usually is utilized at least initially.

Neither of these two tests is especially sensitive or good at detecting any mild and most moderate brain injury. That is, you can suffer a severe injury to the head resulting in mild or moderate brain injury and these tests will not detect anything wrong. In other words, the tests can come back “negative” indicating a “normal” test. That does not mean that there is no brain injury.

Doctors and researchers are experimenting with different types of MRIs in order to detect mild or moderate traumatic brain injury. Diffuse Tensor Imaging is one type of MRI for this. In the words of researchers who have written an article in March, 2004 edition of the American Journal of Neuroradiology at Harvard University Medical School said:

“Multiple bio markers are used to quantify the severity of traumatic brain injury (TBI) and to predict outcome. Few are satisfactory. CT and convention MR Imagining underestimate injury and correlate poorly with outcome. New MR Imagining techniques, included Diffusion Tensor Imaging (DTI), can provide information about brain ultrastructure by quantifying isotropic and anisotropic water diffusion.”

Huisman, Thierry; Schwamm, Lee; Schaefer, Pamela; Koroshetz, Walter; Shetty-Alva, Neeth; Ozsunar, Yelda; Wu, Ona; and Sorensen, Gregory; American Journal of Neuroradiology, 25: 370-376, March, 2004.

In a recent article in the journal Neurology of the American Academy of Neurology, doctors from Baylor College of Medicine and the University of Texas-Houston Medical School concluded:

“Despite normal CT imaging and neurologic functioning, many individuals report post-concussion symptoms following Mild Traumatic Brain Injury (MTBI). This dissociation has been enigmatic for clinicians and investigators.”

These physicians/investigators found that the Diffused Tensor Imaging did detect some changes in the brain within six days after the injury in adolescents. Wilde, ea C.A. THD, et al, neurology, 2008; 70: 948-955 (2008).

In all of the cases studied by the doctors, the people who had suffered MTBI had undergone a CT scan with negative results. That is, the scan found absolutely nothing wrong. Further, these people had a Glasgow coma scale of 15. This is the scale used by the paramedics or Emergency Medical Team (EMT) to gauge the consciousness level of the person. A score of 15 is the highest level of consciousness considered to be “normal”. All of the people studied had negative MRIs; that is, a normal MRI and a normal Glasgow coma scale. The result of the study is that the Diffused Tensor Imaging, even with a normal CT scan and normal Glasgow coma reading, suggesting “cytotoxic edema”, that is swelling of the cells to the point of disease or abnormality, within the brain. This is the microscopic axonal shearing or tearing which occurs with even MTBI. This kind of axonal sheering does not show up or appear on the CT scan.

The only problem with the Diffused Tensor Imaging is that it is not readily available. Many neurologists are not familiar with these recent studies. Further, many neurologists do not deem it necessary to recommend or prescribe such testing.

The neuropsychologist is an expert at testing for brain damage but is not a medical doctor. Accordingly, a neuropsychologist cannot prescribe any testing, even a Diffused Tensor Imaging MRI. The neuropsychologist only can suggest it, but cannot prescribe it.

Post-Concussion Syndrome is a set of symptoms that accompany MTBI. This set of symptoms include anxiety, dizziness, fatigue, headaches, irritability, insomnia, loss of consciousness and memory, and noise sensitivity occurring alone or in combination. “Psychologic and somatic complaints, cognitive impairment, headaches, cranial nerve signs and symptoms and in rare cases dystonia, hematomas, seizures and tremors and the sequelae to mild head injury. Post-Concussion Syndrome may be due to acute cerebral dysfunction or due to psychological response to head trauma. Most of the symptoms generally resolve within six months in most cases, but some persist for years.”

“Diffusion Tensor Imaging, compared to other types of imaging techniques like CT, MRI, EEG, may be an effective tool for the early detection of microstructural changes in the nerves, and in predicting the prognosis of patients during the recovery after traumatic brain injury. Considering the fact that even mild TBI can result in neurobehavioral changes, DTI may be a boon for the early diagnosis, prognosis and treatment of TBI.” Neurology. Wilde, Dr. Elizabeth A.; Dept. of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, 2008, March 18; 70; 948-955; Diffusion Tensor Imaging of Acute Traumatic Brain Injury in Adolescents. Neurology. 2008, March 18; 70; 948-955. See also Sidaros, A. et al; Diffusion Tensor Imaging Suring Recovery from Severe Traumatic Brain Injury in Relation to Clinical Outcome: A Longitudinal Study. Brain, 2008, February; 131 (Pt. 2): 559-72; Kraus, M.F. et al; White Matter Integrity and Cognition in Chronic Traumatic Brain Injury: A Diffusion Tensor Imaging Study. Brain. 2007, October; 130 (pt. 10): 2508-19; Evans, R.W.; The Post-Concussion Syndrome and the Sequelae of Mild Head Injury. Neurologic Clinics, 1992, November; 10 (4): 815-47.

The symptoms which follows traumatic brain injury can include also neurological symptoms (numbness, tingling), physiological symptoms (loss of vision, smell, taste, touch), and attitudinal or psychological symptoms, such as depression.

In a November 18, 2008 Technology Review article (published by MIT) discussed “three novel imaging techniques [which] can detect mild brain damage not visible using traditional methods”. According to the article, and all other researchers and writers, “Mild Traumatic Brain Injury is notoriously difficult to diagnose. The brains of concussion patients often look normal on CT scans, the most common test after head trauma, and cognitive deficits can be subtle, even to a neurologist”. The article is quoting Michael Selzer, a neuroscientist at the University of Pennsylvania.

The brain is made up of white matter, that is the brain and spinal cord are made up of many cells, including neurons and glial cells. Neurons are cells that send and receive electrochemical signals to and from the brain and nervous system. There are about 100 billion neurons in the brain. There are many more glial cells; they provide support functions for the neurons and are far more numerous than neurons. The neuron consists of a cell body (soma) with branching dendrites, which receive signals. There is a projection off of the body of the neuron called an axon. The axon conducts the nerve signal. The other end of the axon, the axon terminal, transmits the electrochemical signal across a synapse, the gap between the axon terminal and the receiving cell. The axon is a long extension of a nerve cell that takes information away from the cell body. Bundles of axons are known as nerves. Dendrites bring information to the cell body. Myelin coats and insulates the axon except for periodic breaks in the axons called nodes of Ranvier. Myelin increases the transmission speed along the axon. Myelin is manufactured by Schwann’s cells, and consists of 70 – 80% lipids (fat) and 20-30% protein.

It is the tearing of sheering of the axons, those cells that carry information away from the conducting fiber that carries information away from the cell that causes the damage that cannot be detected by the CT scan.

The three new techniques for determining and showing traumatic brain injury include the Diffusion Tensor Imaging (DTI), a variation of MRI that tracks water molecules in the brain.

The second new technique or variation of an MRI is known as Magnetic Resonance Spectroscopic Imaging (MRSI).

Do not let the defendant’s attorney deny you fair and just compensation for your brain injury. Work with an experienced Miami injury attorney dedicated to protecting victims’ rights who will fight to ensure you get the compensation you deserve.

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Contact a Lawyer Who Handles Brain Injury Cases

If you have a question that was not addressed above or you would like to schedule a free consultation with a Miami injury attorney regarding a brain injury claim, contact our law office today, and a representative will be in touch with you shortly. Hickey Law Firm, P.A. is a member of The North American Brain Injury Society (NABIS), The Brain Injury Association of America, and the Brain Injury Association of Florida, We represent people from all over the world against cruise lines and others. Call toll free today for a free consultation: (855) 375-3727.