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Traumatic Brain Injury
Whether cases
involving fires, auto accidents, or workplace injuries, the attorneys at
the Brown Law Offices have helped many traumatic brain injury survivors
recover for their losses.
Aside from the practice of law, one of our lawyers has drafted a
comprehensive guide to pediatric traumatic brain injury, found in law
libraries across the state. We've also attended many traumatic brain
injury seminars at the Minnesota Brain Injury Association annual
conference.
Surprising to many, head injuries are the fourth leading cause of death
in the United States, and the number one cause of death in people under
age 40. The head is actually the most common site of all the various
kinds of injuries.
The impact of a head injury extends well beyond the victim, and to the
survivor's family and friends. Quite often, those close to someone who
has suffered a "mild" traumatic brain injury will detect the symptoms of
injury before the victims themselves.
The term "head injury" is typically used to describe traumatic injury to
the brain and associated cerebrocranial structures. Just as the rest of
the body is susceptible to bruising and breaking, the brain too can
endure serious trauma.
It is estimated that over 400,000 head injuries occur annually in the
United States, with an incidence rate of about 200 per 100,000. These
figures only represent those who have been admitted to a hospital. One
recent study has suggested that all head injuries (reported and
unreported) total nearly 8 million annually in the United States.
One kind of brain injury called "concussive-comprehensive injury"
follows both blunt head trauma and trauma that penetrates the skull.
Blunt trauma involves a blow to the head from a heavy object, such as a
bat or pool cue. Whether or not the skull is penetrated, some portion of
the kinetic energy of the blow is transmitted to the brain and other
cranial contents in the form of pressure waves. These waves disturb the
neurological balance within the brain.
Penetrating trauma from a bullet or other projectile produces by far the
most destructive concussive-compressive injury. Damage results from both
the object itself, and the impact forces crushing the brain tissue.
"Acceleration-deceleration" forces may also cause injury. These injuries
differ from concussive-comprehensives. The most common example of an
acceleration-deceleration injury is seen in the victims of motor vehicle
accidents. Damage occurs as a result of the inertial forces, and tends
to be more severe and widespread throughout the population.
When a car traveling at high speed comes to a sudden stop, the body and
head continue moving forward at the original velocity until brought to a
stop after impacting the surface in the vehicle. In just seconds, the
brain is subjected to powerful acceleration and deceleration forces,
transferring large amounts of kinetic energy to the internal brain
membranes.
Every brain injury involves a combination of concussive-compressive and
acceleration-deceleration forces to a certain degree.
There are three levels of trauma that may be distinguished: concussion,
contusion, and laceration. A concussion, very common, is a jarring shock
that damages the brain. A typical hockey or football player can tell you
about these. On the other hand, a contusion involves actual bruising of
the brain tissue. These are obviously more serious than a concussion.
Finally, a laceration involves direct penetration or cutting of the
brain tissue.
Brain injuries may also be classified as "primary" or "secondary."
Primary injuries result directly from trauma, while secondary injuries
appear later as complications from a different primary injury. Secondary
effects are not easily recognized at the onset of a brain injury. In
time, however, the debilitating nature of head trauma presents itself
more fully.
Management of head injuries has improved significantly over the last few
decades, both in diagnosis and treatment. Early and aggressive
management of head injuries will improve the outcome substantially. It
is vitally important that you seek medical care if you believe you have
sustained even a mild traumatic brain injury. Help is available to you.
The treatment rendered will depend upon the grade diagnosis, which can
be either a level I, II, III. or IV.
Grade I is considered a mild injury, and constitutes the vast majority
of trauma patients seen in a hospital. Although awake and alert, these
patients often suffer short-term loss of consciousness or amnesia. Most
recover without difficulty; secondary effects are minimal.
Grade II head injury is moderate, with patient alertness but
sluggishness. They are treated carefully as the patient may easily fall
into a Grade III if left alone. Care is similar to those with more
severe head trauma, including hospitalization, steroid use, and the use
of antiepileptic drugs.
Grade III injuries are severe, and the patient's consciousness is
impaired to the point where she cannot follow simple commands. Doctors
employ an aggressive approach to care, including a host of diagnostic
studies, surgical intervention, psychological evaluations and
therapeutic agents.
A Grade IV brain injury presents no evidence of brain function. Of
course, they are the most serious type of brain injury. While the
perception of society is that the classic "Grade IV" injury is what a
brain injury actually is, these injuries are relatively uncommon.
Aside from traditional physical treatment, physicians will employ a
series of psychological tests in an attempt to diagnose the
"non-physical" injury of the brain. These may include a host of
objective personality tests, the Minnesota Multiphasic Personality
Inventory (MMPI), projective personality tests, and intelligence tests
such using the Wechsler Adult Intelligence Scale or the Stanford-Binet
test.
Cognitive defects present the most unique challenge to brain injury
victims. To the outside world, the injured person looks and acts
completely normal. Inside, however, a "different person" exists.
Treatment is improving and involves retraining for various skills, such
as problem-solving and abstract thinking.
A brain injury patient's prognosis is based on a host of factors,
including: age, length of coma, posttraumatic amnesia, location and
extent of brain lesion, responsiveness, TANS signs, Glascow Coma Scale
score, and other indicia of injury severity. Naturally, your own
physician is in a much better position to offer predictions about your
future.
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