Concussion & Traumatic Brain Injury (TBI)

Finding a doctor for concussion after car accident

What causes a concussion?

A concussion can occur in different ways. Typically, a concussion happens when there is a rapid and forceful back-and-forth movement in the brain.

These impacts usually involve a direct force, such as getting tackled or hit, whiplash during a car accident, falling on the head, or hitting the head on a cabinet.

Since your brain rests in fluid, known as cerebrospinal fluid, there is some protection from common hits or jolts to this area of the body. Yet, this protection does not guard us against all impacts. If the impact has a high enough force, the brain can hit the skull. Differences in cerebrospinal fluid levels can result in different thresholds for concussions and its consequences.

What is a concussion?

When the brain is battered in this way, the nerve endings in the brain can tear and will begin to swell. This damage causes the death of the nerve and brain tissues around the injury.

Usually, this will resolve itself; however, if it is severe enough, it may require surgical intervention to alleviate. Concussions are now known as mTBI or mild Traumatic Brain Injuries. This change in classification is due to the awareness of medical professionals on the seriousness of the injury.

There are around 3 million concussions recorded every year. There has been a marked rise in concussions due to the higher level of participation in youth contact sports, soldiers involved in active combat environments, and a growing aging population with an increased risk of falls.

Who is at risk for a concussion?

All individuals at one point in their lifespan are at risk for a concussion. Typically concussions happen in three main demographic groups.

Infants

Infants or children less than three years old are at high risk for concussions as well. This high-risk level is due to a confluence of factors such as decreased awareness of surroundings, poor balance, and reduced insight into dangers.

Concussions in children are a serious medical emergency, and you should look for signs of reduced neurological function including decreased awake time, no sucking reflex, low language output, and complaints of headache.

Teenagers

Teenagers and young adults that participate in contact sports have a high incidence of concussions. Most of the common concussion-prone sports include football, rugby, ice hockey, combat sports, and lacrosse. However, some athletic activities that are less associated with concussion in the lay person’s mind can also be concussion-prone, such as soccer, basketball, and skiing.

It is crucial that you wear all available head protection and practice safe play when engaging in any sports activity. Teenagers are also at risk for concussions related to the high incidence of domestic violence and assaults. Risky behavior and drinking at this age group increase a chance of assault and violence.

Elderly

Elderly adults and the broader geriatric population are at risk for concussions as well. Similarly to young children and infants, there is an increased incidence of both; the severity and the number of concussions as we age.

This increase is mostly because we lose strength and balance as we age, resulting in increased falls and possible head impact. Additionally, there is less of a chance of recovery in the brain due to age, that can result in more severe concussions.

How to tell if you have a concussion?

There are differences in the immediate and long term effects of a concussion. Some of the most common immediate symptoms of a concussion include: sensitivity to light, headaches, nausea, vomiting, blurry vision, mumbled speech, fatigue, amnesia around the event, and difficulty focusing.

What does a concussion feel like?

Often directly after the injury or hit, like an auto accident, a patient will begin to experience pain and discomfort or the symptoms above immediately.

How to diagnose a concussion?

There is no definitive imaging or blood test for a concussion. Therefore, a healthcare provider must use differential diagnosis.

Differential diagnosis involves taking a wide variety of measurements, then making a diagnosis based on all of these findings. First, the healthcare provider will take a thorough past medical history, etiology, and cause of the incident. Along with subjective information, the measurements that injured’s healthcare provider will take include: blood pressure, vitals, pulse oximeter (measuring oxygen levels in the blood), balance tests, visual field changes, hearing tests, and symptom onset and exacerbation involving head motions. If the symptoms are present, lasting and severe, the healthcare provider can make a diagnosis of concussion.

What to do after a concussion?

After a concussion, it is critical to seek medical attention immediately. This can include going to an emergency room, urgent care facility, or local physician/healthcare provider’s office. Some sensitive blood vessels and structures need to be assessed using diagnostic testing.

At the hospital, if symptoms are severe enough, a concussion doctor will give an fMRI (functional magnetic resonance imaging) or an X-ray to ensure no severe bleed in the brain. Additionally, the healthcare provider will assess reflexes, visual changes, blood pressure, heart rate, and balance deficits.  If the healthcare provider determines that there is no need for extensive treatment, they will send you home.

It is vital to ensure that you drink water, get plenty of sleep, not engage in contact sports of strenuous physical exercise, and reduce the stimulation that you are exposed to. This can include watching TV, reading, or listening to music. You should limit these activities for as long as you experience the symptoms of concussion or until your healthcare provider can tell you to resume activities.

Can you sleep with a concussion?

Sleeping within 8-12 hours of a concussion is not recommended. Sometimes, this can be masking internal bleeding or swelling in the brain.

Frequently, a doctor will recommend that you stay awake immediately after the incident; however, it is essential that you eventually start sleeping at regular intervals to allow your brain to recover.

Can you drive with a concussion?

Due to the effects of a concussion, such as blurred vision, decreased balance, visual changes, and lack of coordination, it is essential that you not drive for 2-6 weeks after a concussion.

If the concussion is severe enough, your healthcare provider might recommend that you not drive for a few months. Operating any machinery or driving a car after a concussion can be dangerous to both the injured party and those around them, and therefore not advisable or recommended.

How long does a concussion last?

It can take days, weeks, or months to recover from a concussion. All of this depends on the severity of the impact, genetics, and age.

For instance, a soccer player getting a concussion from heading the ball will be different from a man falling down the steps and hitting his head on a railing. Due to the variability in a degree of concussion injury and an individual’s age, health, and medical history, we can only give a range of time that a person will require to recover from a concussion. Generally, recovery can be from 5-7 days to 1-2 years at the most severe.

What are the after-effects and their symptoms?

Suffering from the side effects of a concussion after auto accident

Some of the immediate symptoms can include sensitivity to light, headaches, nausea, vomiting, blurry vision, and difficulty focusing.

Some of the long term effects can include decreased memory, poor decision making, loss of balance, impaired judgment, and depression. Many of these symptoms are caused by internal damage that occurs in the brain.

Balance changes can result from damage or changes in the cerebellum or vestibular system. The vestibular system is an organ system that helps us to recognize where our head is in space. This organ system helps with balance when moving your head during walking, negotiating stairs, and changing positions.

After a concussion, disturbances in the functioning and the fluid in the vestibular system can be found. The cerebellum is the apple-size organ at the base of the brain that is involved in coordination. It is massively dense with nerve endings and is easily damaged in severe concussions.

What is post-concussion syndrome?

Post-concussion syndrome is a medical term that involves symptoms such as headaches, dizziness, and cognitive difficulties.

The syndrome can last a few days too many weeks or months after a concussion. Usually, the more concussions that a person has, the higher the risk for post-concussion syndrome.

What is a secondary impact syndrome?

Secondary impact syndrome is severe and sometimes can be a fatal condition. It is mainly seen in combat or collision sports.

Specifically, a person will receive a concussion. Then, instead of limiting their activities following their first concussion, they return to contact sports or combat duties and experience a second concussion within a few days of the first occurrence. These recurrent concussions can cause significant swelling in the brain and even bleeding for the arteries. This swelling can be fatal immediately and can cause a sudden loss of life.

What are other long term effects of concussion?

Repeated concussions over a lifetime can be correlated with other, more significant impairments. Chronic Traumatic Encephalopathy (CTE) has been a new area of research related to repeated head trauma in collision sport athletes and soldiers returning from combat.

Essentially, the repeated concussions and collisions will result in the malformation of proteins around neurons in the brain. This malformation can cause impairments related to memory, speech output, and physical function. Also, there are changes in a person’s mental function that can include: violent behaviors, depression, uncontrollable emotions, and decreased insight.

What are the treatments for concussion?

Other than rest, there are no effective medical treatments for concussion. You should try to get seven to nine hours of sleep each night. Also, you should take a break from watching TV, reading, listening to music, or other cognitively stimulating activities.

In essence, most of the treatment around a concussion involves treating the symptoms related to a concussion. This treatment can include balance, training, and vestibular training.

Balance Training

Balance training includes changing limits of support and putting a patient in a physical therapy program for unstable and stable surfaces. Sometimes, physical therapy can be a useful adjunct to correct balance disturbances.

Strength Training

Strength training will help to improve the persons function so that they can get back to work or prior level. Furthermore, strength training to enhance the strength of the leg muscles will help with balance when walking or performing other functional mobility.

Vestibular Training

There are some medications, such as Meclizine™ (an anti-dizziness medication), that can help with the symptoms of vestibular disturbance and decreased the balance. Also, antidepressants can help to treat long-term psychological problems that can be a result of concussions.

Can you get a concussion from a car accident?

You can get a concussion from a car accident. Usually, the concussion following an auto accident can occur in three different ways. 

Not Wearing A Car Seatbelt

The first way you can get concussion following an auto accident is when someone hits their head while not wearing a seatbelt. This impact on the automobile’s steering wheel or the dashboard against a part of the car can easily cause a concussion.

Air Bag Deployment

The second method is airbag deployment, that may cause a concussion. This forceful deployment of the car’s airbag can cause the back and forth of the brain, thereby causing a concussion.

Whiplash

Finally, the whiplash motion of a car accident, even if they have a seatbelt, can cause a concussion or brain injury.

If you feel you sustained a concussion after a car accident, it’s vital to find an auto accident clinic with a multi-specialty medical team.

Other co-morbidities that happen with a concussion

Due to its forceful and dynamic nature, other injuries can occur with a concussion. These can include whiplash, facial fractures, nerve injuries, and other orthopedic trauma.

With the potential of these traumas happening simultaneously, it can complicate both recovery and medical care because brain injury and trauma can make it harder to heal and rehabilitate.  

How Are Concussions Graded?

Concussions are graded on a scale from one to three. This grading scale is used in the treatment and management of symptoms after a concussion.

Concussion Grade 1

  • No loss of consciousness
  • Slight confusion
  • None or very transient memory loss
  • Very rapid recovery

Concussion Grade 2

  • Loss of consciousness greater than 5 minutes
  • Momentary confusion
  • Retrograde amnesia (forgetting past events)
  • Complete recovery within 5 minutes

Concussion Grade 3

  • Loss of consciousness greater than 5 minutes
  • Confusion greater than 5 minutes
  • Prolonged and unresolved retrograde amnesia (longer than a few days)
  • Slow recovery greater than 5 minutes

How To Prevent Concussions

There are some practical ways to prevent the occurrence of concussions.

Infants And Toddlers

In the infant or toddler age group, proper supervision and barriers around high fall areas are essential. These barriers can include gates around the steps or drop-off areas.

Children and Young Adults

For the younger population, concussion prevention advice typically includes: wearing seatbelts, protective headgear for sport, exercises/balance training, and reducing risky behaviors or activities. Some of these activities include collisions sports or combat sports.

Elderly  

For the elderly population, it can include continuing with the balance and exercise training to improve strength as we continue to age. Additionally, proper use of assistive devices such as single point canes and front-wheeled walkers can be important in reducing the risk of falls and subsequent concussions.

What Kind of Settlement Should I Expect From a Concussion After a Car Accident?

To put it simply, what you can expect to receive from a concussion after a car accident is whatever a jury determines that your case worth. This is because, in a personal injury claim, a jury decides how much it will award you in damages if it finds that the defendant is indeed liable.

However, most people (both plaintiffs and defendants) prefer to avoid the risk, time, and expense of going to trial and would rather settle their cases outside of court. When this is the case, you will have to calculate an amount that you will be willing to accept as a fair settlement of your claim and the insurance company has to be willing to pay you that amount.

If you and the liable insurance company cannot agree upon a settlement, then you will have to go to trial in order to obtain the compensation you need to cover the injuries and losses you have suffered as a result of the concussion you sustained in the car accident.

For an idea of what your New York concussion injury case might be worth, have a look at the range of jury verdicts and settlements obtained in these notable New York traumatic brain injury cases:

$5,000,000 – Ashkinazy v. Consolidated Edison Co. of N.Y., Inc. (1st Dept. 2010)

Myths Regarding Settlement of a Personal Injury Claim

Before discussing what you should expect from your concussion settlement, let’s start by dispelling a few myths about trying to settle a personal injury claim:

A Settlement offer is Not Guaranteed

An insurance company does not have to give you a settlement offer. Often, in car accident claims that involve a second-rate insurance company, a settlement offer is never made. What’s more, if an insurance company feels that there is insufficient proof of liability or that there are complicated medical issues, such as evidence of a pre-existing medical condition, they will most likely not make you an offer to settle.

No Standard Settlement

There is no such thing as a “standard settlement” for any personal injury case. In the past, simple cases were sometimes settled for three times the medical expenses. But, that approach was exploited by unethical attorneys and health professionals and has been abandoned.

No Two Cases Are The Alike

You can’t simply look at similar cases to figure out what your case is worth and expect your case to settle for the same amount. Although the settlements that have been obtained for similar cases is one consideration that an experienced personal injury lawyer will take into account, no two personal injury cases are alike.

What Factors Determine How Much a Concussion Settlement Should Be?

The most important factors in determining the settlement value of your New York personal injury claim are:

 

  • Liability for your injury;
  • The nature of your injury; and
  • Your damages.

 

Liability

With regards to liability for your injury, any questions concerning liability or evidence of comparative negligence will significantly influence the settlement value of your case.

By questions concerning liability, we mean any reason to think that a jury might find that the defendant wasn’t responsible for your concussion or difficulty in proving any other aspect of your case, for example, the cause of the car accident.

Comparative negligence refers to any percentage of responsibility you have for the accident in which you were injured. If you share any of the blame for your concussion, the total amount you can recover will be reduced by your own percentage of fault.

Consequently, any evidence of comparative negligence will trigger an insurance company to assess its overall chance of losing at trial as being less than if no evidence of comparative negligence existed. Besides, there may be other defenses that may be applied to your case and that might lead to the dismissal of the case, or affect how liability is assessed.

The Nature of Your Injury

The nature of your injury is also a critical factor in determining the fair settlement value of your New York concussion lawsuit. Generally speaking, the more severe your concussion, the greater your settlement value will be.

Nevertheless, your concussion must have been a result of the accident in question. If, for example, you had a pre-existing medical condition, a prior concussion, or reason to believe that something else led to you being injured, this may affect the settlement value as well.

Your medical records are also vital. However, you must keep in mind that the insurance company will examine your medical records with the objective of disputing the alleged cause of your concussion and will sometimes enlist the assistance of questionable medical “experts” to dispute causation without any reason to do so.

Damages

Probably the most important factor in determining a settlement value for your concussion is the damages that you have incurred. The law in New York entitles an injured person to pursue the following damages in a personal injury claim:

    • Past and future medical expenses;
    • Past and future lost wages;
    • Past and future pain and suffering;
    • Disability;
    • Disfigurement;
    • Emotional distress; and
    • More

 

Other Factors

Several additional factors come to bear in evaluating a case for settlement:

  • The insurance company involved
  • The amount of insurance coverage available
  • The defendant’s financial circumstances
  • The cost of pursuing the case
  • The length of the case
  • Any supporting witnesses
  • The quality of your own testimony
  • The testimony of your treating physicians

An experienced personal injury lawyer will consider all of these factors when preparing a settlement demand to the insurance company and when making recommendations to you with regards to the settling your case.

Your attorney has an ethical obligation to inform you of any settlement offers that have been made and to advise you with regards to settling. But ultimately, you are the one that must decide as to whether to accept or decline a settlement offer.

The process of reaching a settlement in a New York concussion lawsuit can be time-consuming and involves carefully reviewing the facts of the case, the nature, and extent of your injuries, and all of the other factors that may affect the value of your case. All of this can’t be done during a single phone conversation or meeting with an attorney.

Any lawyer who is prepared to quote you a settlement estimate during an initial phone call or meeting, without first properly evaluating all of the factors in your case, either doesn’t know what he or she is doing or is simply trying to hook a potential client.

Either way, you should look for someone more professional to assist you with settling your concussion lawsuit.

New Advancements in Brain Injury Imaging Can Increase Your Ability To Recover Compensation For A Concussion

Brain injury lawyers are often required to demonstrate to a judge or jury, if possible, the existence and severity of their client’s brain injury. But, this is often very difficult to do.

The reason why this so difficult is because even though medical imaging techniques can detect hemorrhaging in the brain and fractures to the skull, the most frequently used medical imaging techniques––CT scans and MRI scans––can not detect the minuscule damage that has been done to a victim’s brain as a result of the brain injury.

It is, therefore, essential that your brain injury lawyer recognize that conventional CT scans and MRI scans can only produce a picture of your brain, but cannot show the changes that it has undergone as a result of your concussion or brain injury. As a matter of fact, conventional CT scans and MRI scans can’t even indicate if you are asleep, awake, dead or alive, let alone the extent of your brain injury.

But, as is often said in medicine, “absence of proof is not the absence of injury.” And today, new medical imaging techniques are becoming available to help attorneys prove the existence and severity of a client’s traumatic brain injury.

These new techniques are now able to exhibit how the brain is working instead of simply how it looks. One particular technique involves an innovative, more powerful MRI scanner known as Tesla 3 MRI.

The Tesla 3 MRI scanners are twice as powerful as the kinds being used in the majority of medical institutions today and can identify structural changes in the brain that once could not be detected. Equally as important, Tesla 3 MRI scanners can pick up on hemosiderin deposits that follow the tearing of microscopic blood vessels and are an indication that the brain has suffered an injury.

There are also other new medical imaging techniques that enable us to observe how the brain is working. One particular study, known as a PET, scan makes it possible for doctors to examine how well your brain is utilizing oxygen.

The harder your brain works, the more oxygen it needs. PET scans generate colored images of your brain that depict regions of the brain that are not getting enough oxygen as a consequence of damaged brain cells.

With advances in medical technology, such as these, attorneys are better able to explain to a jury what happened in a person’s brain when they suffered a concussion or other brain injury and why compensation is needed to address the need for ongoing care, rehabilitation, loss of income, etc.

Any personal injury lawyer handling a concussion injury case should know about the availability of this new generation of brain studies and how to properly utilize them to effectively convey the nature and extent of your brain injury in the courtroom.

The Use of 3D Animation in Support of Compensation for a Traumatic Brain Injury

In addition, to modern advancements in medical technology that enable attorneys to visually depict the extent of a brain injury like never before, 3D animation can be used in the courtroom to visually recreate the incident and demonstrate the full extent of the injuries you have suffered.

To illustrate, we need look no further than the following case:

In the case of Watts v. Caltrans and The City of Los Angeles, a California man was awarded $9.1 million for a brain injury suffered during a bicycle accident that happened along California’s Pacific Coast Highway.

This case dealt with a gentleman by the name of Robert Jeffrey Watts. Mr. Watts had been riding his bicycle along Pacific Coast Highway, when he came to an area of the highway where the debris from a landslide had made its way onto the road.

To avoid the debris, Mr. Watts was forced to go into a lane of traffic, where he was sideswiped by a truck. The force of the impact threw him into the face of the rock cliff alongside the road. When Mr. Watts hit the rock cliff, he suffered a severe brain injury.

One of the biggest challenges that Mr. Watts’ attorneys had in handling his brain injury lawsuit against Caltrans (the entity responsible for maintaining and operating the California State Highway system) and The City of Los Angeles, was the fact that when Mr. Watts entered the courtroom, he looked absolutely fine and like nothing were wrong with him. So, why would a jury award Mr. Watts a huge amount of money for his concussion injury?

Another challenge Mr. Watts’ attorney had to overcome was the fact when Mr. Watts suffered the injury to his brain, he lost all memory of the incident. Because of this, his lawyers could only piece together what must have happened to him in the accident from the testimony of various expert witnesses.

Nothing tells a story better than being able to see it unfold before your very eyes. Knowing this,  Mr. Watts’ attorneys decided to put together an animated depiction of his story.

This animation spliced together the various aspects of the incident in which Mr. Watts was injured, and presented them to the jury in one cohesive story, including:

  • The events that caused the accident;
  • The injuries that Mr. Watts sustained in the accident;
  • How those injuries affect his body and everyday life;
  • The recovery process Mr. Watts had undergone; and
  • Mr. Watts’ prognosis for the future  

This animation represented the closest version of what actually happened on the day of the accident that anyone could have unless there was actual camera footage of the incident and its aftermath.

The human mind’s ability to accept information is so much more powerful when this information can be visualized. If the jury can view what you went through with their own eyes, this can leave a very powerful impression.

This impression can be the difference between recovering the compensation you deserve for your brain injury or not. And in this case, it was enough to help Mr. Watts’ attorneys obtain an award of $9.1 million on his behalf.

Conclusion

A concussion is a complicated injury that can be devastating for patients that experience it. It usually involves different types of therapy to help alleviate, including therapeutic exercise, medications, balance training, antidepressants, and other modalities. Concussions can have long-lasting effects, it’s important to find the right concussion doctor as soon as you can.

The process of reaching a settlement in a New York concussion lawsuit can be time-consuming and involves carefully reviewing the facts of the case, the nature, and extent of your injuries, and all of the other factors that may affect the value of your case. All of this can’t be done during a single phone conversation or meeting with an attorney.

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