Brain Injuries

Your Medical Records Being a good patient can be challenging under any circumstances.  The challenges can be particularly unique when a mild traumatic brain injury is involved.  There are certainly compelling medical issues at play, for certain, but also matters that can have a serious impact on any lawsuit that might be brought.  Awareness of these medical/legal issues, and knowing how to handle them, can sometimes make the difference in winning and losing.  That difference is often lurking in the content of your doctor’s medical records.  How accurate are they?  Are they comprehensive?  Do your medical records reflect just how

Definitions Obviously, when this degree of brain injury is involved the circumstances are much more challenging and patient needs considerably more extensive.  These situations can be very difficult and a great challenge not just for the injury victim, but the entire family. Moderate and severe traumatic brain injuries are characterized by symptom severity according to certain prescribed criteria. Though far from precise, certain observable and measurable markers show up within 7 days of the trauma and are fairly reliable to classify brain injury severity (mild, moderate, or severe). These include the presence and duration of loss of consciousness, post-traumatic amnesia

Brain Neurons Neurons are the “working” cells within the brain and central nervous system and are responsible for all brain communication within and throughout the body. Neurons have a specialized structure which allows them to transmit signals in the form of electrical impulses from the brain to the body and back. Transmission is continuous, occurs at amazing speeds, and involves chemical components known as “neurotransmitters” that help make the signally possible. There are 3 types of neurons: sensory neurons, motor neurons, and interneurons. Each have different functions and the brain needs all of them to communicate effectively with the rest

Frequency of Injury The numbers are staggering.  A half million youngsters each year are taken to emergency rooms with head injuries from falls, motor vehicle accidents, sports, and abuse. Approximately 165,000 of these children will be hospitalized with 20,000 suffering moderate to severe symptoms.  These numbers are alarmingly high, in part, because of the unique characteristics of the infantile, underdeveloped brain. Susceptibility of the Young Brain The young brain is particularly susceptible to traumatic injuries because: brain neurons, and other structures and systems, are underdeveloped leaving them more vulnerable to traumatic events, immature brain neurons when traumatized tend to release

What is a concussion? Don’t be confused. A concussion is a mild traumatic brain injury (MTBI) and should be taken seriously. Just ask the NFL. Physicians often use the terms concussion and MTBI interchangeably, which can lead to confusion and a tendency to understate and under appreciate the significance of a concussion. The Centers for Disease Control defines a concussion as follows: “The term mild traumatic brain injury (MTBI) is used interchangeably with the term concussion. An MTBI or Concussion is defined as a complex patho-physiologic process affecting the brain, induced by traumatic biomechanical forces secondary to direct or indirect

Things You Can Do There are certain things you can do to help recover from a concussion. Many involve helping your brain heal itself. Get plenty of sleep at night, and rest during the day. Avoid sustained computer use, including computer/video games, early in the recovery process. Avoid activities that are physically demanding. Avoid activities that require a lot of concentration, such as balancing your checkbook. Avoid activities, such as contact or recreational sports, that could lead to another concussion. Limit exposure time to bright lights and loud sounds. When your healthcare professional says you are well enough, return to

Frequency of Injury The number of children and adolescents in this country who sustain traumatic brain injuries (TBIs) and concussions is staggering. A half million youngsters each year are taken to emergency rooms with head injuries from falls, motor vehicle accidents, sports, and abuse. Approximately 165,000 of these children will be hospitalized with 20,000 suffering moderate to severe symptoms.  Thankfully, a vast majority of these ER visits involve relatively minor concussions, but nonetheless these must be taken seriously by parents and treating clinicians. Observation is the key to successful concussion recovery in children. Recovery Phases With prompt attention most children

A Secondary Injury Process Not all brain damage occurs at the moment of trauma.  Far from it.  Brain damage occurring in that moment is considered a primary injury.  It’s generally held, however, that the most significant damage in the cycle of traumatic brain injury occurs after the primary injury with the onset of secondary injury processes placed in motion by primary injuries.  Excitotoxicity is one of several secondary injury processes and is a toxic condition in the brain caused by damage to brain neurons and to the blood-brain barrier.  Excitotoxicity is a highly complex and destruction injury process, and as

What is a hematoma? A bruise (contusion), wherever located, is a collection of blood outside a blood vessel following trauma to that site. We are all familiar with contusions just underneath the surface of the skin following a bump or blow, but the brain can bruise too following trauma, with or without direct head contact, with the same accumulation of blood outside blood vessels. Brain hematomas and almost exclusively diagnosed by CT scans. These are serious conditions which require close monitoring, and in some cases immediate and direct surgical intervention. Brain hematomas can not only cause brain damage at the

An Inflammatory Response The body reacts to injury, including brain injury, with a predictable inflammatory response. Swelling (edema) is a manifestation of that response and is the result of increased blood flow which brings white blood cells to the injured site, and the movement of other fluids, to help heal the injury. Edema is a sign of an underlying problem, but not the disease/injury itself. Brain swelling (cerebral edema), which can last up to 5 days post-trauma, can be in specific locations within the brain, or over widespread regions of the brain, and can be a direct or indirect response