How do I prove a Traumatic Brain Injury?

Posted in medical treatment on September 24, 2020

Whether it be in the movies or on various television talk shows, traumatic brain injuries in children and young adults and athletes has come to the forefront recently.  There have been lawsuits in the NFL and in school districts because the effects of a head injury last years after the injury actually occurs.  The focus of this post is to make parents and caregivers aware of how life really can change in a dramatic way from a childhood brain injury.

WHAT IS CONSIDERED A BRAIN INJURY?

In recent years, strides have been made in the areas of brain injuries, in part because many vets have returned with head injuries from overseas.  For us regular folks though, a simple hit in the head while playing, a fall or even banging your head and being diagnosed with a mild concussion falls under the category of brain injury.  The longer the initial hospital stay, and extent of treatment will help doctors classify the severity of the brain injury.  That being said, never underestimate the effects of even a mild brain injury.

HOW IS A TRAUMATIC BRAIN INJRY DIAGNOSED?

More often than not, if a child has a head injury, it usually results in a trip to the emergency room.  In the field, the emergency personnel will conduct a Glasgow Coma Score.  This measures how alert the patient is, their responses to stimuli and if they are able to talk coherently.  A GSC of 8 or less is considered a severe TBI.  9-15 is moderate TBI to mild TBI.  The GCS is conducted upon contact with the patient in the field.  If the score indicates a TBI, it will be repeated every four hours to monitor how stable the patient is. In order to diagnose a TBI, a series of tests will be run upon admission to the emergency room.  The first set of testing is usually a CT Scan which can show if there is bleeding, fractures, or swelling. If the GCS and CT scan indicates a TBI, a neurologist will be consulted and perform further tests such as an MRI.  This can pinpoint the exact are of injury as well.  Usually in the event of a TBI, your child will be kept for observation and treatment depending on the severity of the injury.

WHAT CAN HAPPEN TO MY CHILD AFTER A HEAD INJURY?

Depending on the age and extent of your child’s head injury, any number of things can occur that you should be on the look out for. Changes in personality, trouble in school, the inability to concentrate, accompanied with trouble sleeping can all be signs of a head injury.  Bear in mind that even if your child loses consciousness for even a brief time, the effects of a brain injury can be more severe, and these problems can last even into adulthood.  The neurologist treating your child will more than likely call in a vocational therapist to help the patient to adjust to life with a TBI. This can be anything from memory exercises, teaching basic life skills, and later in adolescence, teach a job skill that can help them feel productive and provide a sense of independence.

You may notice changes in behavior, such as being more irritable, having angry outbursts or other personality changes may affect a child after a head injury.

WHAT CAN HAPPEN IN ADULTHOOD FROM AN EARLY BRAIN INJURY?

There are studies that have been performed all over the world, and most of them say about the same thing.  Having a childhood brain injury, losing consciousness when that injury occurs, and a diagnosis as simple as a mild to moderate concussion can affect a child decades after the injury.  Problems may not even occur at the time, and the patient can appear normal with a mild dip in grades and maybe some depression.

More severe brain injuries that includes physical presence of the injury on x rays and scans can result in these adults being 80% more like to have to collect a disability pension.  These adults are 10% more like to develop more that one psychiatric disorder that requires lifelong treatment and the occasional institutional stay.  Doctors said there could even be a 2% spike in suicides among adults with brain injuries.  Short term memory loss can happen in adulthood decades after the injury.  Depression is very common with brain injuries and is usually a lifelong problem after the injury occurs, again, depending on how severe the injury. The ability to obtain a college degree is markedly decreased in young adults who suffer an early childhood brain injury.  Studies have even show early childhood brain injury can result in some adults dying before the age of 41.  The premature death of an adult usually occurs for those who suffer the more severe brain injuries.

WHAT CAN BE DONE TO HELP CHILDREN AND ADULTS SUFFERING FROM BRAIN INJURY?

When you have a child who has suffered a brain injury, experts have said that being aware of changes that occur in your child’s behavior and addressing them with the physician can help guide you through the treatment process.  Having access to mental health services for children and young adults who suffer a brain injury is also a key component to treatment.  Having the ability to get supportive care and assessments for cognitive development may help to tackle problems head on.  Children/young adults trying to cope with the setbacks of a head injury need to have an environment that is stable, calming and relaxed.  If the patient’s personality changes after a head injury or their skill levels change after the head injury, it is imperative that caregivers and family members NOT compare now to “before”. This is frustrating and difficult for patients to deal with.

HOW DO I PROVE A TRAUMATIC BRAIN INJURY?

When it comes to proving a brain injury, it is more subjective than objective.  TBIs cannot be seen unless accompanied by paralysis, physical debilitation, etc.  More often than not, the “golden hour” is going to be a basis of establishing the injury.  The Golden Hour refers to the moment the injury happens up to getting them to the hospital and treatment started.  In a trauma situation, it can be a matter of life and death.  The documentation that is done in that critical hour is a great place to start when it comes to establishing TBI. As most TBI results in mental health, personality, and cognitive changes in a patient that are lifelong, how the patient is treated upon injury and arrival to the ER is key in determining the basis for a TBI.  Even if there are not significant catastrophic changes on brain scans and tests, that does not mean a TBI is not devastating to the patient.  Getting the patient mental health support, documenting changes that occur after the injury, and having a vocational therapist working with the patient and documenting progress and obstacles will all be helpful in establishing a case for your attorney.  Having a TBI, even a mild one, can permanently alter a patient’s life.  The care and support that they get as soon as possible is going to be key in how the effect of the TBI are going to impact teen years, and well into adulthood.  Documenting every concern or change you notice and having it placed in the patient’s record will also be a key element in making sure you have let providers know if you feel something is wrong.

HOW TO COPE AS AN ADULT WITH THE LASTING EFFECTS OF A BRAIN INJURY.

No matter how much time has passed since the brain injury, depression, mood changes, cognitive ability and memory loss may very well remain.  What you also need to remember is that normal health issues that adults experience can present in a more serious manner or the symptoms be more exaggerated if there is a brain injury.  This is because in a brain injury, the brain’s ability to transmit and receive information and responses has been forever altered.  Paying attention to new symptoms that may occur, how you feel when they do occur and making sure you are monitored by the appropriate physicians is going to be a lifelong routine.  This is not always reassuring, but the brain is not like a heart or a liver.  Those organs do the same things every day of your life.  The brain is the one organ that is one of a kind.  Everyone’s brain reacts differently to everything that happens to us. It is important to understand when an injury of the brain occurs, just because you may think it is not worth mentioning to your doctor, any changes you notice, need to be communicated.  There is not a surefire method to cope as each person is different.  There are common denominators present for those who do suffer brain injury, but coping is a personal journey and must be trained and learned by those who know how to help brain injury patients deal with everyday life.

IN CONCLUSION…

It is a foregone conclusion that there is no such thing as a brain injury that is not serious.  Every head injury needs to be taken seriously.  As with any injury, some can be worse than others and the course of treatment is going to be different for each patient. Even an injury in toddler years can cause problems for the rest of the patient’s life.  There is no “cure” for brain injury, only coping mechanisms and treatment that can be done to sustain life and make sure the patient is stable.  A lifelong of operations, psychiatric treatment, and learning how to cope each day with the obstacles that can be a brain injury are all doctors can promise.  Having a supportive environment with routine can help.  Making sure a patient has access to these forms of treatment is key to a good quality of life following a brain injury.  Children will not “grow out of” head injuries, it will follow them the rest of their lives.