The common nature of TBI (traumatic brain injury) is not well-known, yet it has been called the “silent epidemic,” touching almost 1,500,000 Americans every year, with most of those cases being what is categorized as “mild,” or involving a loss of consciousness of less than 30 minutes. As we always tell jurors, “mild” means just that, loss of consciousness for less than 30 minutes, and in no way relates to the effect on the person who took the hit to the brain, who will often describe the after-effects as devastating, catastrophic, anything but “mild.”

Sometimes the person in a TBI case did not even get hit on the head. For example, we have represented many people whom the experts say suffered a TBI from acceleration/deceleration forces, like those which can cause a “whiplash.” These forces can lead to serious and widespread injury to the delicate billions of axons, or pathways within the brain, in phenomenon known as coup-contra coup injury, or diffuse axonal shear.

A coup-contra coup essentially means that the person, who might have their head go forward rapidly, then backwards, in perhaps 1/10th of a second, suffers trauma within the brain, to the part of the brain where the forces originated, and then on the rebound inside the brain, the reverse region, or other side, gets injured too.

Diffuse axonal shear is the snapping of tons of axons within the brain when such acceleration/deceleration forces are in play. The whipping motion causes the brain to be injured in various ways, not to most people, but to those who do get hurt. The density of the grey matter and white matter within the brain is distinct, and the brain can have a “ripping” or “shearing” inside in an instant given the right forces and angles, and never recover thereafter.

The brain can get injured in car crashes, even with no direct trauma, or in other violent events. In the hours and days following the initial injury, secondary brain trauma can also occur from fluid buildup within the skull, decreased oxygen supply or reduced blood flow, so the injury can get worse than is originally noted.

It is not uncommon for a TBI to be diagnosed days or weeks later, but the person was seen in ER, evaluated by skilled doctors, had a brain CT scan that looked clear, and released. You cannot judge whether there’s a TBI injury based on the car crash or immediate medical records alone, but you do need to know what they do say.

TBI cases are often very expensive and labor-intensive.

Like a pure psychic injury case, or a serious but controversial pain case, like a chronic regional pain syndrome case, they are emotional. We rely on scientific evidence to prove our case, and then we make every effort to visually explain the issue so a jury, or a business we’re negotiating with, can evaluate and understand the magnitude of the claim.

Our clients often see psychiatrists, neurologists, neuropsychologists, neuroradiologists, neurobehavioral specialists, life care planners, physiatrists, cognitive rehabilitation specialists, and others who work with TBI patients.

Although you need the right experts, you’ll often win or lose the case with the credibility of collateral witnesses, the neighbors, the former co-workers, others in the plaintiff’s life who can explain the difference in the person before and after.

Here is a link to the Brain Injury Association of California–Click here

The initial event has to meet certain criteria. There must be a period of loss of consciousness. This may be met, according to many experts, by a period of “altered” consciousness. A period may “be there” but not really….the lights are on but nobody’s home, that sort of thing. Think Troy Aikman walking off the football field heading to the wrong team’s bench…or think about a boxer staggering to the wrong corner or the neutral corner. Then, there must be a period of memory loss for the event and things happening immediately before or afterward. Some criteria require other details, but usually, the person does not have a prolonged loss of consciousness.

TWe ask an array of questions to people who we think might have a TBI, but here are some short lists of things to inquire about:

Sensitivity to:

• Light;
• Noise;
• Touch;
• Crowds;
• Busy environments;
• Movements;
• Heights.

Reports changes in:

• Vision;
• Taste;
• Smell;
• Muscle strength;
• Ability to concentrate;
• Memory;
• Reading;
• Auditory comprehension;
• Paying attention;
• Fears;
• Safety;
• Judgment;
• Decision making;
• Initiation and execution of a task;
• Planning;
• Speed of processing;
• Temperament;
• Sleep;
• Eating;
• Sexual drive;
• Social isolation/involvement;
• Quality of, or ability, to work;
• Behavior.

Complaints of:

• Dizziness;
• Poor balance;
• Nausea;
• Fatiguing easily;
• Ringing in ears;
• Recurrent headaches;
• Motion sickness;
• Sensitivity to touch;
• Depression;
• Anxiety;
• Increased irritability;
• Sleep disturbances;
• Disorientation and confusion;
• “stop-stare” episodes (seizures).

Most people recover from TBI within two years; however, sadly, statistics show that maybe 15% or more never fully recover. They are the people who will live a life with a broken brain, losing things, scared, difficult to employ, difficult to live with. Your job as a lawyer is to find a way, through the witnesses you’ve met and the medical evidence you’ve gathered, to tell this story. We do that.