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"Mild" Brain Injuries

This article describes "mild" brain injury causes and effects. "Mild" is the term some experts use for brain injuries that are not associated with a loss of consciousness. Unfortunately, "mild" brain injuries can have catastrophic results, both on the life of the injured person and the lives of the people who live around him or her. "Mild" brain injuries can cause subtle, but important changes that are hard to diagnose and hard to recognize. Many people don't even go to a doctor. When they do, doctors often miss the diagnosis because the symptoms are hard to define and the microscopic damage to nerve cells doesn't appear on an MRI or a CT scan. Yet the damage is there.

How do "mild" brain injuries occur? When a person's head is subjected to sudden forces of acceleration and/or deceleration. Usually this involves an impact directly to the head, but not always. For example, in a rear end automobile accident where a stopped car is hit at 40 miles per hour, the head can be snapped back and forth, causing a sudden acceleration deceleration of the brain. That is enough to cause nerve cell damage.

It is very important to understand that a person doesn't need to hit a windshield at high speeds to sustain a brain injury. Falling and hitting your face or head on a desk, or a stair, or a chair, getting hit on the head in a fight, walking head first, into an open cabinet door, something falling and hitting you on the head can all be enough to cause brain injury. Some of the immediate symptoms may, but not necessarily, include dizziness, feeling woozy, having a big bump and bruising.

People with brain injuries complain of feeling, "out of focus". It is a hard to describe "fuzzy feeling" that doesn't go away. It's been described as looking at the world through an opaque shower glass. Other symptoms include: Increased emotionality, irritability, having a shorter fuse, easy loss of patience, crying more. Loss of short term memory is manifested by forgetting everyday things, like where you put the keys or your purse. People who never left a pot on the stove find they have burned a pot or two since the accident, or have left the garden hose running. People complain of forgetting conversations, having people tell them they are repeating themselves, needing simple instructions repeated but still not comprehending them. Some people notice they have difficulty concentrating on reading, increased headaches, getting lost in familiar territory, panicking, or "flooding", not knowing what to do or say and so not doing or saying anything. Other symptoms are more subtle, such as not being able to organize things as you could before the accident, not being able to make decisions, not being able to prioritize effectively, being distracted easily, not being able to focus in a room full of people.

Often, when people are confronted with the possibility of having sustained a brain injury, they say, "I didn't even lose consciousness." The fact is, a loss of consciousness is not a prerequisite to having sustained a brain injury. A person in a rear-end accident, will say to me in the office, "I didn't even hit my head on anything!" The fact is, you don't have to actually hit your head to suffer a sudden acceleration/deceleration injury to your brain.

So I tell them, "You tell me you have lost the ability to concentrate, you are more emotional, you have lost some short term memory, you can't organize things the way you used to, you are more compulsive, you obsess on things now, you may have lost your sense of smell, or taste, you may have been depressed since the accident, or have lost your usual energy level, maybe you're more sensitive to noise or light. You've had headaches. You get dizzy. You may have sustained a brain injury. It's worth checking it out."

How?

A neuro-psychologist is trained to administer tests that can identify performance levels. These can be analyzed to determine a person's post accident level of functioning. They can not quantify an actual loss of functioning attributable to the accident unless pre-injury tests had been administered. The results can be used to extrapolate a good estimate of the loss of ability based on perceived pre-injury levels of functioning.

Impaired memory, impaired concentration, headaches, increased emotionality can be embarrassing to the people who suffer from them. They cause errors and mistakes at home and at work that are frustrating and incomprehensible to the people making them. Suddenly, without any explanation, something that was simple before the injury becomes impossible. You fail a test you should have aced, the names or phone numbers of good friends are forgotten, projects don't get done on time. You just don't know where the time went.

These failings are often initially denied or not recognized by the injured person. They try to get around them, rationalize. They have friends cover for them, for awhile. These seemingly inexplicable failings lead to errors, which leads to anger at oneself, or at others, which leads to more frustration, more stress, maybe depression.

If you, or a loved one has experienced a sudden acceleration/deceleration of the head as a result of any accident, at work, or in a car, you may have a situation where you sustained more damage than you initially thought. I have handled various types of head injury cases and am sensitive both to the problems of the injured individual and the problems of proving the injury in court. Please call my office at 408 615-5300 or email me. I will be happy to review the circumstances of your case and provide you with more personal legal advice.

A good book describing an emergency room doctor's personal experiences with her own head injury is, "Over My Head" by Claudia L. Osborn.

Copyright    May, 2000: Michael J. Richter

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