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Showing posts with label mild traumatic brain injury. Show all posts
Showing posts with label mild traumatic brain injury. Show all posts

Friday, May 15, 2015

Brain Injuries and Bicycle Cases

By Jim Freeman

We see brain injuries over and over in our bicycle cases.  The severity of theses injuries varies widely from a headache to permanent functional brain damage.  My experience is that there is no bulletproof preventative when it comes to brain injuries.  Although helmets may help to reduce injury, bicyclists who use helmets suffer brain injuries too.  If the hit is hard enough you may still sustain a brain injury despite proper helmet use.

Rural collisions tend to yield a higher percentage of head injuries than collisions in town.  Speed limits on rural roadways tend to be much higher than speed limits in town.  In my experience, speed of the automobile at time of impact is directly correlated with the likelihood that a given accident will result in catastrophic injuries.  The faster the vehicle, the more likely that injuries sustained by a bicyclist will be severe. 

Your brain has the consistency of gelatin suspended in fluid.  It is cushioned from everyday jolts and bumps by the cerebrospinal fluid in which it floats.  In an accident you may experience a blow to the head causing your brain to bounce forcefully against your skull.  This can result in bleeding in or around your brain and damage to nerve fibers.  Common symptoms of a brain injury are loss of consciousness, memory loss, headaches, nausea or vomiting and slurred speech.

Concussions are fairly common brain injuries.  People who have had a concussion in the past are at higher risk of having concussions in the future.  The concern after a concussion is that the blow to the head may have caused serious bleeding or swelling inside the skull. Symptoms of such injuries may not appear until hours or days after the injury.

If you experience symptoms of a concussion it is best to see a doctor.  Neurologists typically specialize in such injuries.  A doctor may prescribe a CAT Scan or conduct a neurological exam.  Such an exam usually includes checking your memory and concentration, vision, hearing, balance, coordination and reflexes.  People who suffer concussions often suffer from post-concussion syndrome in which concussion symptoms last for weeks or months following the accident.  I often hear client who have suffered a head injury complain of "fogginess" or an inability to concentrate.  Such injuries should be taken seriously and examined by a specialist.

A common story we hear when a bicyclist is struck by a car goes like this;

The last thing I remember I was riding my bike down the street, then I woke up in the hospital with my family around me.

When a bicyclist is struck by a car and they hit their head it is common to experience some loss of memory around the time of the accident.  In such a case it is important that you conduct a independent investigation to determine how the accident happened before you speak to the driver's insurance company.

You should understand that some insurance companies will take advantage of your loss of memory.  We see time and time again that negligent drivers are all too prepared to lie about the events of an accident because they are worried about their own liability or an increase in their insurance rates.  The driver will give a statement to his insurance company that blames the bicyclist for the collision.  If you can't remember how the accident happened the insurance company will defend the case based on their insured's version of the events.  Your claim may be denied outright.

At my law firm we have years of experience investigating collisions in which the bicyclist can't remember what happened.  We conduct our own investigation and do not depend on the police or driver statements for a determination of fault.  It is always best if the client calls us before calling the insurance company in such an instance.  It is also best if we get the case as soon as possible.  Evidence starts to disappear or be destroyed the moment the accident occurs, so it's best if we can start our investigation as soon as possible.   

Tuesday, March 25, 2014

Bicycle Crashes and Brain Injury

Courtesy of Sunday Is For Lovers
It may not take much to injure that gelatinous cauliflower inside your cranium.  Suffering even mild trauma to your head can begin a process that leads to years of muddled thinking, spotty memory and poor focus, among other things.  That was the message delivered and received at a conference on traumatic brain injury that I attended last week in San Francisco, hosted by the North American Brain Injury Society.


A traumatic brain injury is a disease process that begins with an event, i.e., an impact, a skull fracture, a cut or laceration.  Having your head whacked may begin a long term condition that never goes away, and may indeed get worse over time.  Often, the severity of the brain injury is measured by the size of the whack, the degree of impact, the amount of blood.  This is wrong.  The severity of the injury is to be measured by the effect it has on the injured person's life over time.  Sometimes a seemingly minor whack can have profound consequences.  These consequences may include problems with attention and concentration, poor memory, problems with initiating a task, problems with organization, difficulty stopping a particular behavior, increased anxiety, mood changes and problems with impulse control.  There may also be an increased risk of Alzheimer's type dementia and/or earlier onset of age related dementia.  One need not lose consciousness or suffer intracranial bleeding to have sustained a brain injury.  The damage is often at the microscopic level that cannot been seen on CT or MRI scans.  It is enough, that there was an incident, an impact, and symptoms.

Once concern has been raised by the presence of symptoms, specialized medical testing can be run to determine if there is indeed a traumatic brain injury, or what is termed neurocognitive disorder due to traumatic brain injury in the latest edition of The Diagnostic and Statistical Manuel of Mental Disorders (DSM-5).  This is done by having a properly trained expert run neuropsychological testing.  This battery of tests is designed to run the test taker through a series of tasks used to measure particular functions that are know to be linked to a particular brain structure or pathway.  If testing reveals a problem with a particular function then that is powerful evidence of damage to a specific area or area(s) within the brain.  Specialized radiological testing can also be done to uncover additional objective findings of brain injury.  Diffusion tensor imaging (DTI), sometimes also called diffusion MRI, looks at microscopic details about the brain's tissue architecture to highlight areas of injury.  These tests are very helpful in assisting physicians and psychologists to determine where the brain has been harmed and how.

If you are involved in a crash it is important for you and those close to you to pay attention for possible signs and symptoms of a significant brain injury.  Some 15 years ago the first case I ever tried involved a mild traumatic brain injury.  The defense in that case asserted that because my client looked fine and sounded fine he was fine.  It was only after speaking to the people who new him best, his wife and children, who discribed disconcerting changes in the man's behavior since the incident that we worried that the injury was more severe than initially thought.  We had neuropsychologists test him and learned that he indeed sustained a major brain injury.  Do not hesitate to follow up with your physician if you are continuing to have problems even several months following a crash.  He or she may decide to refer you for testing to determine whether you have a brain injury.

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