A traumatic brain injury (TBI) can severely change your life. These types of injuries are much more common than most people realize. According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 223,135 Americans were hospitalized in 2021 with TBIs, and nearly 70,000 deaths in 2019 could be attributed to traumatic injuries to the brain. The CDC notes that many more people likely suffered TBIs that didn’t result in admissions to the hospital or were undetected because people failed to seek treatment.
TBIs can range in severity from mild concussions to permanently disabling injuries. These injuries happen when a victim receives a sudden external blow or a penetrating injury to the brain. When people sustain TBIs because of the actions of others, they might be able to recover monetary compensation for their losses by filing an injury claim. Since a TBI is a hidden injury and isn’t something that can easily be seen, you might wonder how you would go about proving a TBI in your injury claim. According to brain injury attorney Steven M. Sweat of Steven M. Sweat, Personal Injury Lawyers, APC, proving a brain injury will require you to present expert testimony and diagnostic results of various tests to show you suffered an injury to your brain as a result of someone else’s negligent or intentional actions. Here’s what to understand about TBIs, their common causes, common types of diagnostic tests, and the presentation of evidence required to prove a brain injury case.
Understanding Traumatic Brain Injuries
Traumatic brain injuries are damage to the brain that can result from a blow or jolt to the head or body. Some TBIs are called closed injuries because the damage occurs within the skull without a penetrating object. Penetrating injuries are caused by an object penetrating through the skull.
These types of injuries can have immediate effects or delayed effects. The primary effects or injuries are those that appear right after the injury occurs. Secondary or delayed effects are injuries that can develop gradually over hours, days, or weeks. Secondary injuries can happen when someone doesn’t receive immediate treatment for a TBI and can result when the damage spreads because of reactions that can occur in the brain.
Someone can suffer a TBI even if they do not suffer a blow to the head. For example, if someone is violently shaken or thrown around, the motion can cause their brain to slosh around inside the skull and strike the bone. A TBI can also occur because of swelling and fluid placing pressure on the brain and causing tissue damage.
How Do TBIs Happen?
While anyone can suffer a traumatic brain injury, older adults are particularly at risk and account for nearly one-third of all hospitalizations for TBIs. The National Institute of Neurological Disorders and Stroke reports that the most common causes of traumatic brain injuries include the following:
- Falls
- Motor vehicle collisions
- Sports-related injuries
- Assaults
- Explosions (especially in the military)
Falls can happen when someone is working and falls from a height to a lower level when they are not provided with adequate fall protection. They also can happen when a property owner or business fails to fix broken pavement or tile, torn carpeting, and other similar issues. A common danger that can lead to falls and TBIs is an uncleaned spill left on the floor of a busy store.
Motor vehicle accidents of all types, including car, truck, motorcycle, truck, pedestrian, and bicycle accidents, can cause traumatic brain injuries. When someone suffers an injury in a motor vehicle accident or a fall on someone else’s property, they might have the legal right to pursue compensation by filing a brain injury claim. To file a claim, the injured victim will have to prove the other party was negligent.
Proving Negligence in a Traumatic Brain Injury Case
The person who files a claim for a TBI after being involved in an accident is called the plaintiff. A plaintiff always has the burden of proof, which means they must present enough evidence to show the incident and their injuries more likely than not happened the way they claim. Most injury lawsuits involve a negligence cause of action. To prove negligence, the plaintiff will need to present evidence proving each of the following things:
- The defendant owed a legal duty of care to the plaintiff.
- The defendant violated the legal duty of care.
- The defendant’s breach of duty caused the accident and the plaintiff’s injury.
- The plaintiff suffered calculable damages.
If the plaintiff can’t prove one of the elements but can prove the others, that won’t be enough to succeed in a claim. Instead, the plaintiff must prove each of the elements by a preponderance of the evidence, so they will need to make sure they gather and present enough evidence to prove each element. In a fall or motor vehicle accident that results in a TBI, proving that the defendant’s actions caused the accident, and the plaintiff suffered a TBI as a result, will require the plaintiff to present medical evidence. In most cases, this will require the testimony of a medical expert who can explain complex medical terms to a jury to show how the injury happened, where it is located, and its impact on the victim.
Presenting evidence of the diagnostic tests that were performed and how they indicate a TBI occurred can be important. Showing that the victim sought medical treatment soon after the accident is also important because it can show the TBI likely resulted from the accident instead of a different incident. Below are some of the tests that might be performed and how they might help to prove a brain injury.
Glasgow Coma Scale
The Glasgow Coma Scale is one of the first assessments doctors perform when they suspect a TBI. Doctors perform a number of tests and then assign a score ranging from three to 15. A three indicates the person is in a coma, while 15 means they are functioning normally. Mild, moderate, and severe TBIs will have scores between the two. If the person’s score on the GCS indicates an abnormal mental status, the doctor will perform additional tests.
CT Scans
Computerized tomography (CT) scans are commonly used to help diagnose TBIs. This involves taking numerous X-rays of the head and brain and can show brain bleeds, fractures, bruised tissue, and damage. In some cases, doctors will inject a radioactive dye into the patient to reveal more details.
MRIs
Magnetic resonance imaging (MRI) is often performed later to identify changes in the brain as they occur. An MRI shows more detail than a CT scan and can reveal subtle changes that can occur. Unlike a CT scan, an MRI uses magnets instead of X-rays to produce images of the brain. However, an MRI often can’t be used to diagnose mild TBIs.
Volumetric Brain Measurement Scans
Volumetric brain measurement scans involve some post-MRI processing to evaluate the volumes of different brain structures and compare them to standard norms. This type of scan might be used to check for neurodegeneration following a TBI. It is also used to render a realistic picture of the brain’s cortical surface and can help to differentiate atrophy from a TBI from atrophy caused by other neurodegenerative conditions such as Alzheimer’s disease or normal aging.
MRI Perfusion Scans
MRI perfusion scans evaluate how much blood different areas of the brain take up to see how they are functioning. Active areas of the brain show higher blood and oxygen use while inactive areas show very little. With the use of a radioactive tracer, doctors can see the highly active areas and superimpose images from perfusion scans over CT scans to compare the imaging information from both.
Diffusor Tensor Imaging Scans
Diffusor tensor imaging (DTI) scans are more advanced imaging tests that can help doctors track damage and changes in the brain over time. Like an MRI, a DTI uses magnets to produce images, but it also analyzes how water molecules are diffused and can use that information to look at the brain’s white matter. The images produced by DTI might indicate whether some damage may have occurred at the microscopic level.
Susceptibility Weighted Imaging Scans
Susceptibility-weighted imaging relies on magnetic resonance imaging that can detect deoxygenated blood. SWI scans provide high resolution to allow doctors to identify injuries that are difficult to see on other types of imaging scans, including diffuse axonal injuries, microbleeds, and shearing.
Magnetic Resonance Spectroscopy (MRS)
Magnetic resonance spectroscopy (MRS) can be useful for diagnosing mild TBIs because it evaluates the presence of different metabolites in the brain. Some metabolites are produced when the brain undergoes changes, and others that indicate neuronal integrity might decrease when someone suffers a mild TBI.
Postron Emission Topography (PET) Scans
PET scans use a radioactive tracer that is injected into the patient’s body for the imaging test. The brain will absorb the tracer. Radioactive tracers tend to pool in areas that are damaged or injured, so a PET scan can help doctors pinpoint where the damage has occurred.
Vestibular Balance Testing
Some people who suffer from TBIs will have balance problems. Vestibular balance testing evaluates the vestibular system in the ears, which helps people to maintain balance while walking, running, and moving. Vestibular balance testing might involve multiple tests to evaluate the patient’s balance in different situations.
Optometric Testing
Vision begins in the brain, so an individual with a TBI could suffer damage to the visual cortex. According to the American Optometric Association, up to 75% of people who suffer from TBIs will also suffer from dysfunction of their vision. Optometric testing can reveal previously undiagnosed and suspected TBIs and help to prevent further visual problems through referrals for appropriate treatment.
Speech-Language Pathology Testing
Many people who suffer from moderate or severe TBIs will develop speech-language disorders. Speech-language pathology tests can help to diagnose different disorders and show how they originated from the TBI. They can also be helpful for creating a comprehensive treatment plan that addresses all of the symptoms someone with a TBI might suffer to aid in the rehabilitative process.
CONCLUSION
Traumatic brain injuries can cause lasting damage and problems that people might have to deal with for the rest of their lives. When a person suffers a TBI in an accident that was caused by someone else, the injured victim can pursue a legal claim to recover compensation for their injuries and other losses. Presenting medical evidence will be important for proving a brain injury claim, including any diagnostic tests that were performed and expert testimony about the injury and its potential impact on the victim’s life and ability to function.