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PERSONAL INJURY - BRAIN INJURIES

The force involved in a car crash can send occupants and possessions flying around inside the vehicle. Often, airbags will deploy from the force of the impact. Bumpers are designed to protect cars, not people.

For many people injured in a car crash, the brain is also injured. The sudden acceleration and deacceleration forces can throw the brain around inside the head, bruising the brain, causing microscopic internal bleeding and swelling, which is known as concussion. A concussion is a form of traumatic brain injury (TBI).

The rapid movement of the head from the forces from the crash cause the brain to hit the inside of the skull damaging the brain. The force of the head hitting the deployed airbag can cause a second impact to the brain, causing more damage to the brain. This is known as a coup contrecoup injury, and involve cerebral contusions, a type of traumatic brain injury in which the brain is bruised.

These brain injuries are not detected by xray, CT scans, nor by common MRIs. In fact, most MRI and CT scans will not detect a concussion or TBI.

There are a variety of symptoms associated with concussion or TBI, and symptoms can vary by the person. Common symptoms include:

  • headaches or ringing in the ears;
  • feeling light-headed or dizzy;
  • a feeling of "having your bell rung";
  • blurred vision or fatigued eyes;
  • being easily irritated or angry;
  • trouble with memory, attention or concentration;
  • bothered by lights, sounds or distractions;
  • changes in sleep, including more or less;
  • less effective social skills;
  • mood swings;
  • depression;
  • anxiety;
  • inability to multitask;
  • repetitive behaviors;
  • changes in self-esteem

These are some of the common symptoms of a concussion, these symptoms will show up days or weeks after the crash, or longer. Most often, the injured person does not recognize these symptoms exist, and it is the spouse, family members or friends who notice these symptoms, many of which can be described as "cognitive problems."

A history of a prior concussion or brain injury makes the person more susceptible to another brain injury, particularly brain injuries from a car accident causing the head to move and stop rapidly, especially when the airbags deploy.

Emergency responders, like paramedics with the ambulance, or emergency room doctors, often do not recognize the symptoms of traumatic brain injury because they are looking for injuries that are life threatening, or for internal organ damage or broken bones.

Often, brain injuries are subtle and take time to recognize. Other injuries might be more painful, and mask the immediate symptoms of a brain injury, like headache, dizziness, confusion and fatigue. There does not have to be a direct blow to the head, but can be caused by the acceleration and deacceleration forces involved in the collision, which violently throws the head, particularly when airbags deploy. Many of these symptoms can therefore be missed by paramedics or emergency room doctors, or attributed to other more obvious injuries or shock.

Common symptoms of a brain injury include:

  • mild or profound confusion or disorientation;
  • problems remembering, concentrating or making decisions;
  • headache;
  • light-headedness, dizziness, vertigo, or loss of balance or coordination;
  • sensory problems like blurred vision, seeing stars, ringing in the ears, bad taste in the mouth;
  • sensitivity to light or noise;
  • mood changes or swings, or personality change;
  • fatigue or drowsiness;
  • changes in sleep patterns, or inability to wake up

Diagnosing a brain injury in children can be challenging because very young children may be unable to let others know they feel different. A child with a brain injury may show the following signs:

  • changes in eating or nursing habits;
  • persistent crying, irritability or crankiness;
  • lack of interest in favorite toy or play;
  • changes in the way the child plays;
  • changes in ability to pay attention; 
  • changes in sleep patterns;
  • loss of a skill, like toilet training;
  • loss of balance, coordination or unsteady walking;
  • vomiting

Diagnostic testing like magnetic resonance imaging (MRI) or computed tomography (CT) most often do not detect the microscopic damage to the brain. Neuropsychological testing measures brain functioning, and is one of the most reliable measures of brain damage, assessing memory, concentration, information, processing, executive functioning, reaction time and problem solving. In the days or weeks after the concussion, about 15% of brain injured people develop post-concussion syndrome (PCS) according to the Center for Disease Control (CDC). People can develop this syndrome even if they never lost consciousness, or were unconscious for only a few seconds. The symptoms include headache, fatigue, cognitive impairment, depression, irritability, dizziness and balance trouble, and apathy. These symptoms can last many months, even years.

More information can be found at the National Institute of Neurological Disorders and Stroke; the Brain Injury Resource Center (email: brain@headinjury.com) and the Center for Disease Control.

 

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