One thing that is frightening about the injury is that the brain damaged people look normal. For example, the Marines who come back look perfectly fit because their bodies are in good shape. However, one Marine described in a recent Los Angeles Times (www.latimes.com) article that he can’t throw a football or play a pickup game with friends. Why? He can’t catch anything and he can’t remember the plays. He reports that his thinking has “gone down” and that he can’t remember what he did even earlier that day. This Marine has trouble speaking clearly and gets mad because he can’t understand the magazine that he is reading. If you look at him, you would never know that he has a brain injury. This problem of people looking normal when they have a closed head injury or brain injury is a problem we see a lot with clients who have been hurt in car accidents and have suffered a closed head or brain injury. They look normal but they, in fact, have these classic symptoms of post concussive injury. It often takes quite a while for the brain injury to be diagnosed. In the case of the Marines, they are taught to be tough and not complain. It is similar with a lot of people who get hurt with brain trauma in a car wreck. They don’t want to admit to themselves or others that they are having the brain function difficulties they are having.
Typically, brain injuries do not show up on regular MRIs or CAT scans. There is new, modern and expensive technology in the form of PET scans which can help diagnose brain function. However, this brain scan is not commonly used until the brain injury is discovered by physicians or neuropsychologists who specialize in diagnosing brain injury. In the context of a personal injury case, a lot of times the insurance defense lawyer will make a big deal of this delay in diagnosis. The insurer will try to convince a jury that the person hurt in the car wreck didn’t really suffer a brain injury because it took a while for it to be discovered and diagnosed. However, that delay is very much the nature of this disease of closed head injury or post concussive syndrome. Another complication of diagnosing brain injury in victims of car wrecks as well as military personnel has to do with overlapping symptoms between mild brain trauma and other psychological injuries such as post traumatic stress disorder.
Post traumatic stress disorder also called PTSD is another medical problem common to both people who were in war and in car wrecks. If the person suffers through an event which feels life threatening and continues to have persistent intrusive thoughts about it, like in the form of nightmares, then they may have post traumatic stress disorder. Some of the symptoms in common between traumatic brain injury and post traumatic stress disorder include anxiety, memory loss, depression, and loss of concentration. As a result of this overlap, it may take a while for the patient, their family, and the health care providers to figure out exactly what injuries have been suffered. Another interesting aspect of the information coming back about injured soldiers has to do with how many more brain injuries there are that are of the “closed brain” type of injury rather than those with open visible wounds. A study by the Defense and Brain Injury Center at Walter Reed Army Medical Center in Washington shows that there are probably far more closed head injuries than open injuries to the head by a factor of 7 to 1.
Some doctors with the military think the number may be far greater. In a personal injury case involving brain trauma, the insurance defense lawyers often say that the plaintiff couldn’t have suffered a brain injury if they didn’t actually hit their head directly against the window or windshield. This is not true. Just the jarring of the head being moved backwards and forwards can cause tearing at the cellular level of the brain tissue inside the cranium. Doctors who treat these kinds of injuries are aware of this injury mechanism. In injury litigation, it is necessary to bring in these doctor expert witnesses who can explain medically how it is that closed head injuries and mild traumatic brain trauma work. In the context of returning veterans, the Army is going to start looking more actively to find which soldiers have suffered brain injuries. This silent injury is a real epidemic that the public is not really aware of. Insurance companies defending car wreck and other injury cases want to hide the nature of the problem and its prevalence so as not to have to pay fair compensation to the families of the loved ones who have suffered closed head injuries, mild traumatic brain injury, or post concussive syndrome.
About the Editors: Shapiro & Appleton& Duffan personal injury law firm is based in Virginia (VA), near the NE North Carolina (NC) border and handles car,truck,railroad, and medical negligence cases and more. Our lawyers proudly edit the Virginia Beach Injuryboard, Norfolk Injuryboard, and Northeast North Carolina Injuryboard as a pro bono public information service. Lawyers licensed in: VA, NC, SC, WV, DC, KY.