Brain Injury: The Walking Wounded

A recent medical study of professional football players has showed that brain injury is a more significant problem, than thought. However, brain injury has probably been ignored or down played in the NFL and the medical community for a long time. Because brain injury is not always as obvious as some kind of a broken bone, it is easier to forget about or treat the injury as less than a real problem. This recent study showed that there is a major loss of function that occurs to football players who have repeated concussions over the course of a career. These players are the walking wounded. They walk around and look relatively normal, but their brains have been hurt and it has real effects on their lives.

In the field of personal injury law, we have been paying more attention to brain injuries recently. Other names for this trauma include closed head injury or post concussive syndrome. Whatever label is used by the doctors, this injury, which often results from automobile accidents, is very serious. The brain, itself, is soft like jelly and is encased in a hard structure, the skull, which is like a box with sharp points facing inward. If you take that box with jelly inside and shake it violently, there is going to be some tearing of the jelly. This tearing happens on a microscopic level. It can occur even without the head hitting a particular object like a windshield during a car wreck. Just the violent back and forth whiplash movement in a typical rear ender automobile accident may cause brain injury.

One of the problems with diagnosing brain injury is that it may not be immediately obvious at the emergency room or to the doctors just after the automobile accident. For example, even if a CAT scan is run, which is the normal way to look at the brain, this will not necessarily show the kind of tearing at the microscopic level which occurs in such injuries. Although sometimes there will be some obvious internal bleeding in the brain on a CAT scan, it is also just as common that brain injury is missed at that emergency room juncture. Typical questions asked of the person in the automobile accident like “did you lose consciousness” are fairly useless. If you, in fact, lose consciousness, you may not know or remember it. Most typically, the patient, after being seen in the emergency room, is given a set of instruction sheets about concussion and that is the end of it. Unless the patient or their family brings the possibility of brain injury to the attention of the treating physicians, it may well be ignored.

Ultimately, the brain injury has got to be diagnosed by a physician, typically a neurologist. The complex symptoms from a brain injury can often be confused for other medical problems. For example, some of the symptoms of a brain injury are headaches, memory loss, loss of concentration, irritability, depression, and other somewhat vague or diffuse symptoms which a family doctor or internist may not treat as coming from the automobile accident and a potential brain injury. Often, it takes a while for the patient and their family to realize that there is something more going on than the usual problems associated with a car wreck. Hopefully, the person who has suffered a brain injury gets in the hands of a neuropsychologist who is trained to determine if a brain injury has occurred. In Virginia, there is only one MD who has specialization in treating brain injuries and is also a psychiatrist. That doctor is named Dr. Greg O’Shannick. He is so busy that it is very difficult to get in to see him even if the person wants to travel to Richmond, Virginia, to get treatment. However, I have seen Dr. O’Shannick work miracles by knowing exactly the right treatment to give people with brain injuries that can greatly lessen their suffering.

Sometimes I, as the personal injury attorney, am called upon to help the client in an automobile accident case to realize that they may have a brain injury. Although I typically try to stay out of medical decisions for my clients who have been involved in car wrecks, this is one area where some attorney involvement may be required. Unlike knowing to go to an orthopedist for a bone injury, most typical people who have not been involved in a serious car wreck before may not realize that brain injuries are a real problem and are treated by certain limited medical specialists. More information about brain injury in Virginia (VA) can be found at www.biav.net, the site for the Brain Injury Association of Virginia (VA).