New York Accident and Injury Lawyers: Brain Injuries
Powers & Santola · Personal Injury Attorneys · Albany and Syracuse
The brain controls every aspect of our lives. A slight injury to the brain may result in a significant alteration in how we think, move, interact with the rest of the world, and even who we become.
If a loved one suffered a serious and life-altering brain injury in a car accident, workplace accident, or through a doctor's malpractice, the team at Powers & Santola can offer you thoughtful legal counsel and ethical, high-quality representation in pursuit of full and fair financial compensation.
Please continue reading to learn more about brain injuries.
- Signs and Symptoms
- Causes
- Anatomy
- Brain Mapping
- Overlooked Brain Injuries
- The Large Band-Aid
- Presenting the Effects of the Brain Injury in Court
- Overcoming Cynicism
Please call our offices in Albany or Syracuse toll free at 866.689.9692 for a free consultation. You may also contact us via e-mail for answers to your important questions or to request an appointment.
Signs and Symptoms of Brain Injury
Medically, brain injuries are classified as Mild, Moderate or Severe. This ranking tends to incorrectly suggest that the results of a brain injury may only have a mild or moderate effect when, in fact, the consequences are life-altering.
Symptoms of brain injury may range from the obvious, such as paralysis, loss of speech, vision, hearing, taste, or smell, seizures or the inability to connect with the outside world (as with a person in a coma or “locked in syndrome”); or the symptoms may be more subtle, such as when a person has difficulty recalling events or words, focusing on a task, or exhibiting a change in behavior or personality.
The obvious brain injuries are quickly recognized by everyone. The subtle brain injuries, however, can be easily overlooked, not appreciated, and even misunderstood by those who interact with a brain-injured person.
Signs and symptoms include:
- Loss of consciousness
- Confusion or agitation
- Headache/dizziness
- Vomiting or nausea
- Sensory changes
- Mood, behavior or personality changes
- Inability to awaken from sleep
- Loss of control, function, movement or weakness of any extremity or muscle group
- Loss of coordination
- Changes in thinking ability
Causes of Brain Injuries
Brain injuries may be caused by a variety of events such as when trauma occurs to the head or brain, or as a result of an illness such as meningitis, Parkinson’s disease or stroke. The actual event that results in injury can vary from common occurrences like auto accidents, falls or gunshots, to the less obvious situations which may occur during the birth process, while under anesthesia, due to infections after dental work, or even when there is a rapid change in air pressure such as a plane taking off or landing. In either situation brain tissues and cells are damaged by:
- Disruption of blood flow
- Lack of oxygen
- Disruption of necessary nutrients
- Increased pressure from brain swelling, growth of a tumor or a bleeding inside the skull
- Shearing, tearing or stretching of the connections between the cells
- Toxins
Brain Anatomy
There are three distinct parts to the brain:
- The brain stem, also called the hindbrain, is located at the top of the spinal cord. It was the first part of the brain to evolve. It is responsible for the involuntary functions like breathing, circulation, body temperature, swallowing and gastric control, consciousness, sneezing, coughing
- The cerebrum, or midbrain, provides the smooth control and coordination of all the body's movements. While it does not make the decision to perform an action like ride a bicycle, type, or dance, once the decision is made it allows the body to perform the task without conscious effort.
- The cerebellum, or forebrain, is the most recent section to evolve. It is what separates humans from all other species. It allows us to learn, reason, imagine and be creative, and governs our emotions and behavior.
Brain Mapping
By experimentation, scientists have identified what parts of the brain control the different functions the body can perform. Each motor function and sensory function has been identified with a specific section of the brain by a process known as mapping. This allows medical providers to pinpoint the location of injury by the corresponding loss of motor or sensory function; or conversely, to determine the consequences of an injury to a specific part of the brain.
- Pons control eye and face movement
- Medulla is responsible for our involuntary function which include consciousness, breathing, the heart, temperature, swallowing, hunger
- Controls motor functions (coordination of movement, touch, vision, hearing) as well as certain cognitive or thinking abilities, such as learning, solving problems, reasoning, emotions
The Overlooked Brain Injury
Consider a person who has sustained multiple life threatening injuries such as in a car crash - emergency medical providers are trained to assess and address the patient’s ABC: Airway, Breathing, and Circulation. The failure of any one of these vital functions may lead to death before the patient reaches the hospital.
Upon arrival in the Emergency Department, the patient will be triaged (meaning an overall assessment of the patient’s injuries and the prioritization of the order in which each injury will be treated). Trauma surgeons will repair damage to vital organs, stop bleeding and restore circulation first, while fractures of the limbs can wait several days before treatment. Obvious trauma to the head and brain (as with an open scull fracture) will have a high priority, but subtle injuries to the brain are easily overlooked during the chaos that follows a serious accident. Often subtle injuries will not appear until days or even months later.
Patients and their families may complain of problems such as having to repeatedly answer the same question for the patient, or noticing difficulty with simple conversation because the patient stumbles over words or calls objects by the wrong name, or that the patient seems to act inappropriately and just doesn’t seem to be the same as before. Yet the doctors fail to act upon these symptoms. There are several factors that contribute to this:
- Doctors are highly specialized, often ignoring complaints outside their field
- Doctors have limited direct patient care relying upon assistants to keep them informed
- The more individuals involved in patient care the greater the risk of miscommunication:
- Failure to accurately make entries in the patient’s chart
- Failing to read or consider what others wrote in the chart
- Rushing to discharge the patient from the hospital
- Patients are not healthy enough to understand or recognize all problems they have
- Hospitalized patients usually do not need to engage in higher level brain functions
- Compared to the severity of the life threatening injuries these are considered minor
- Failure to recognition of the impact and consequences of the subtle brain injury
The Large Band-Aid
Recovering from a serious accident is a slow process. At first, patients and their families are generally grateful just to have survived the accident. As the healing continues there is a feeling of relief as basic activities and functions are restored.
As the recovery process slows or stops, frustration and impatience is substituted for understanding. Also, the patient and family may see a complete recovery from the physical injuries and incorrectly believe they are left with no consequences at all from the accident.
This may lead to mislabeling subtle brain injuries as emotional or behavioral problem, laziness or lack of concern. Problems in school or at work may be due to cognitive deficits caused by the subtle brain injury. Because there is no outward sign of injury, like a wheelchair, a brace or a “large Band-Aid on the forehead”, people quickly forget about the severe accident and its long term effects.
Ways to help identify subtle brain injuries:
- Consider that every brain injury has consequences; it is only a matter of time and degree
- Seek an evaluation by a neurologist
- MRI, CT, Spect and Pet scans, angiograms or ultrasounds may evidence brain injury.
- EEGs may help but are of limited value, only measuring surface activity of the brain
- Formal neuropsychological testing can identify learning and thinking disorders
- Vision testing by a neuro-ophthalmologist
- If the area of the brain injury is known, learn the function it controls or is responsible for
Presenting the Effects of the Brain Injury in Court
Life in the 21st Century is moving at an accelerating pace. We are subjected to a steady flow of information and required to make multiple choices based upon that information several times per day. This has led us to focus more on quick “bullet points” or “sound bites” for information. We speak in terms of “the bottom line” and send text messages in cryptic formats. There is constant competition for our attention, which leads to a search for a quick resolution to a problem. We are expected to do more in a shorter period of time requiring us to prioritize our time or engage in “multi-tasking” just to get through the day. As a consequence subtle brain injuries are more disabling than in the past. How to demonstrate such an injury when there is limited time to teach others is difficult but not impossible, especially in a court of law.
Ways in which to accomplish this task include:
- Learning the relevant medicine and knowing what people will and will not understand
- Knowing the different ways in which people learn new information best
- Presenting facts through multiple formats: charts, videos, anatomical models, computers
- Keep the facts short and to the point
- Making the presentation interesting and entertaining yet appropriate
- Have the requisite experience in presenting brain injuries in court
Overcoming Cynicism
During a brief interaction with a person who has sustained a subtle brain injury, people often can be heard to say …
"He looks normal."
"She can answer questions without difficulty."
"He is back in high school, or in his old job making as much money as before."
"The family should just be thankful he is alive."
"She sounds no different than the kid next door when she talks."
"Everyone is looking to blame someone else for their own problems."
"We all have problems, get over it."
Subtle brain injury may be characterized by some skeptics and cynics as nothing more than an excuse for not achieving more. As time goes on, there is a disconnect between the brain injury accident scenario and the life long problems that result. Sympathy, understanding, patience and accommodations begin to fade.
Some suggestions to educate the cynical:
- Use before and after evidence, like comparing standardized-testing results
- Hear what people close to the injured person have to say about before and after changes
- When current post accident school reports appear normal, be prepared to establish that teachers wish for the best and will tend to minimize deficits rather than “label” the patient
- Co-workers “cover” for one of their own, allowing the injured to perform less demanding jobs
- Brain-injured patients don’t want to be see themselves as having deficits, so they engage in denial
- Have the patient examined by the appropriate experts to identify the subtle brain injuries, recommend treatment strategies, and quantify the losses caused by the deficits
Traumatic Brain Injuries for Lawyers
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Contact Powers & Santola today to schedule a free consultation with an experienced lawyer regarding any serious brain injury caused by another's negligence or wrongful acts. Back to Top
