The brain is perhaps the most complex organ on this planet; it controls our thoughts, our feelings, and our body’s regulatory functions such as breathing and blood flow. Approximately 1.7 million people annually suffer a brain injury, of which 52,000 die as a consequence. If you or a loved one has sustained a brain injury in the Chula Vista area due to someone else’s negligence, you may be entitled to compensation. Chula Vista San Diego brain injury attorney Howard Kitay can help.
What Is a Brain Injury?
When someone sustains a blow to the head or suffers a medical emergency that affects the brain (which we’ll discuss in a minute) then they have sustained a brain injury. The severity, type, and recovery from these brain injuries vary greatly. The brain is not a hard substance, nor is it locked in place in our skull. It can move around if impacted by enough force, and it can break down if it doesn’t receive enough oxygen or blood flow.
There are many types of brain injuries; traumatic, acquired, and mild. There are many, many more ways in which to sustain a brain injury; car accident, stroke or playing sports. If you have suffered a brain injury in any fashion, it’s important to seek medical attention as soon as possible. The longer a brain injury goes without treatment, the greater the risk of never making a full recovery.
Brain injuries can also be placed into two distinct main categories. One is a closed head injury, in which the skull remains intact but the brain has made a significant impact on its inner wall. This usually includes concussions, strokes or hematoma. The other is an open head injury, in which the skull gets punctured.
This can produce quite a bit of blood, and as with any head wound, this sometimes makes it look worse than it actually is. But that doesn’t mean that it shouldn’t be taken seriously. The brain doesn’t have any nerve receptors, which is how a lot of people can have a cut or gash on their heads and not even realize it.
How Is a Brain Injury Detected?
Usually, a person will report anything from dizziness to nausea, or even just a mild headache after suffering a brain injury in any form. Before hooking that person up to any sort of machine, they will assess the extent of the injury using what’s known as the Glasgow Coma Scale (GCS), which was introduced in 1980 and is now used in more than 80 countries. It measures three things:
- Ability to speak: This will take into account not whether the person is able to say words at all, but if those words are slurred, slow, or confused in nature.
- Ability to open eyes: Again, it’s less whether the person can or can’t open their eyes, but how they open them.
- Ability to move: This involves a combination of many things. It’s not just the ability to move arms or legs, it’s the ability to grasp something, respond to sensory stimulation, or reaction time.
The GCS uses a 15 point scale to assess the seriousness of the brain injury; 3-8 is considered severe, 9-12 is moderate, and 13-15 is mild. Of course, there are many factors that doctors consider for this test to be as accurate as possible. For example, pre-existing conditions such as a speech impediment, learning disorder, or even a language barrier would be noted when assessing the person’s ability to speak.
To go in hand with the GCS, neurologists will use other indicators to determine the seriousness of the injury, such as how long the person was unconscious (if at all) or how long the memory loss (if there was any) lasted. If the brain injury was sustained due to force or impact, many neurologists will also conduct an Acute Concussion Evaluation, which has an extensive symptom checklist and considers a person’s medical history in order to give as accurate an analysis as possible.
Then there is the MRI and CT scan. A CT (computed tomography) scan is essentially an X-ray that can detect bleeding, aneurysm or a tumor. An MRI (magnetic resonance image) provides a much more detailed picture of the brain than a CT scan, as it provides the anatomy of the brain and which parts of it are functioning. It’s usually used in follow-up treatment as opposed to getting an initial diagnosis because it takes too long.
What Are the Common Symptoms Of a Brain Injury?
Other than the neurological effects of a brain injury that an MRI or CT scan will detect, the physical effects will make themselves apparent by the changes of behavior in the person. As we mentioned previously, there are essentially three terms that define the seriousness of a brain injury:
- Mild: Dizzy or light-headed, confused, blurred vision, ringing in ears, bad taste in mouth, fatigue, and mood changes are just some of the symptoms of a mild brain injury.
- Moderate: Symptoms of a mild injury, plus nausea or vomiting, worsening or consistent headache, inability to be woken from sleep, dilation of pupils, weakness or numbness in extremities.
- Severe: Symptoms of mild or moderate injury, plus a taste of spinal fluid, seizures or convulsions, paralysis, slowed pulse or breathing, loss of bowel or bladder control.
The types of symptoms displayed will vary depending upon the type of injury that was sustained. Where on the brain the injury occurred has a large effect as well.
What Is the Difference Between an Acquired Brain Injury and Traumatic Brain Injury?
A stroke and a concussion are clearly different injuries, and the steps a neurologist will follow in terms of diagnosis and treatment are distinct.
A traumatic brain injury concerns all the blunt force and impact injuries that can happen to the brain. Falling, a car accident, sports injury, gunshot wound, or otherwise hitting your head would be categorized as a traumatic brain injury. So a TBI is an external force.
An acquired brain injury includes TBI, but can also be a stroke, tumor, aneurysm, or multiple sclerosis. Stroke is by far the most common of these, with an estimated 795,000 new cases every year.
Are Concussions Considered a Traumatic Brain Injury?
In short, yes. It is referred to as a mild traumatic brain injury, the term “mild” is used to describe the circumstances under which the injury was sustained, not the consequences of that injury. For the majority of people, full recovery is possible depending on correct diagnosis and treatment. And there are certainly degrees of concussion.
A concussion happens when the brain slams into the inner wall of the skull. The force of that impact, and what happens to the person, as a result, is what determines the severity of the concussion. Observed symptoms can range from headaches, confusion or weakness, to full-on nausea, decreased coordination, or numbness. The real danger of a concussion is that it might not be diagnosed right away, therefore delaying necessary treatment.
The proper treatment for a concussion consists of rest, medicine, and contact avoidance. Sleep is when your body recuperates, so taking it easy will help the brain heal. When taking headache medicine, it’s important to avoid aspirin or ibuprofen, as they thin the blood and could cause a hemorrhage. Finally, stop all physical activity for a little while. Perhaps the worst thing that can happen is a second head injury before the first one is healed.
Second impact syndrome is when someone sustains another blow to the head before their concussion from the first hit has fully healed. This can oftentimes be fatal, because the brain loses its ability to manage the automatic functions that we don’t have to think about doing, such as breathing or heartbeat. Symptoms of this can be dilated pupils, loss of consciousness, or respiratory failure. This is why it’s so important that the first concussion be taken very seriously, no matter how mild.
What Is the Brain Injury Recovery Process?
Treatment and recovery from a brain injury depend on the type and severity of that injury. Unlike with many other injuries such as cuts or broken bones, recovery does not improve on a steady or consistent basis. There will be good days and bad days as the brain heals, but if treated properly, many can make a full recovery. The Rancho Los Amigos Levels of Cognitive Functioning Scale is used to gauge a person’s ability during the recovery process. It has 10 levels, and each one describes how the brain is recuperating after an injury:
- Level 1– No Response: The person appears to be in a deep sleep, and does not respond to verbal, audio or touch stimuli.
- Level 2– Generalized Response: There is a reflexive response to painful stimuli, but they are significantly delayed, and the person needs help with most functions.
- Level 3– Localized Response: There is a better response to all stimuli; they turn toward noise or blink when light crosses their vision. However, the ability to recognize most people is absent.
- Level 4– Confused/Agitated: The person is extremely agitated and confused, and is subject to drastic or sometimes violent mood swings. Their response to a stimulus may be disproportionate, such as screaming due to a simple pinprick.
- Level 5– Confused-Inappropriate/Non-agitated: Anger has mostly left the person, but they may have a tendency to wander with only a vague idea at best of what they’re doing. They can accomplish simple tasks with direction or cues but are unable to learn new information.
- Level 6– Confused-Appropriate: They will start to remember people they may have just recently met, such as hospital staff, but their memory is remote at best and still need assistance with many simple tasks.
- Level 7– Automatic-Appropriate: Tasks that the person was able to complete before the injury can now be done again with minimal to no assistance. Social interaction will still be hindered, the person will tend to overestimate their abilities and the concept of consequences won’t be understood.
- Level 8– Purposeful-Appropriate, Stand-By Assistance: The person has functioning memory, and is able to distinguish past and recent events. They are aware of and responsive to their environment, and can usually complete all tasks after only one instruction. They are still subject to moments of irritability, mood swings and have low frustration tolerance.
- Level 9– Purposeful-Appropriate, Stand-By Assistance on Request: Their ability to multi-task has returned and they can go through all of their daily routines without assistance. If they do need assistance with something, they will ask. This willingness to acknowledge any impairments is crucial to their continued recovery. They may still be easily irritated and have low frustration tolerance.
- Level 10– Purposeful-Appropriate/Modified Independent: The person can now multi-task in all environments, but may require periodic breaks. They are able to help themselves with their memory, and social interaction is consistently appropriate. Bouts of depression and irritability may still exist, but at this point, the person would be considered fully healed.
The recovery process for a moderate to severe injury is not quick. It usually takes years for someone to regain just a majority of their cognitive function. Studies show that two years after the initial injury, 34 percent of patients still require some manner of supervision during the day and/or night.
Part of the recovery process, as we discussed a bit with concussions, is prevention. For acquired brain injuries, such as a stroke, this may require a drastic re-evaluation of how one lives their life. They may have to completely change their diet in order to manage diabetes or high cholesterol. They will have to carefully monitor their medications, as they usually have to be taken at a precise time to be effective. They may also have to quit smoking or greatly reduce alcohol intake, even if it wasn’t that high to begin with. These are changes that will have to last for the rest of their lives, whereas a person who suffers a traumatic brain injury, so long as it wasn’t severe, will likely be able to resume their normal lives before the injury.
What Is the Cost of Brain Injury?
A brain injury requires consistent and careful treatment during the recovery process, which begins immediately after the injury itself. Because a brain is an organ and not a bone, healing will usually take a long time, which means hospital stays and doctor visits even years after the fact. In just one year, the CDC estimated that the total cost of traumatic brain injury was $76.5 billion. Severe and/or fatal TBI accounts for 90 percent of that. This is because a severe injury costs an average of $3 million, while a mild one only costs $85,000 on average.
In terms of the complete recovery of cognitive abilities, 52 percent of those who sustain a moderate to severe brain injury were disabled one year after the fact. While a person can usually recover physical abilities, the way their brain functions in terms of problem-solving and social interaction will forever be hindered.
Why Seek Legal Action For a Chula Vista Brain Injury?
We’ve just gone over the cost of a brain injury, and if it was caused due to someone else’s negligence, then compensation should be sought to cover medical bills and any other costs incurred because of the injury. Approximately 17 percent of brain injuries happen due to car accidents and are the cause of 32 percent of brain injury deaths. At 35 percent, falls caused the most traumatic brain injuries. Many times, falls and car accidents happen because someone else was negligent.
A brain injury can cause more than just high medical bills; lost wages or lost earning capacity, loss of consortium, emotional distress, and property damage all things for which someone has a right to be compensated. This is where settlement offers come into play, as everyone wants to know how much they could potentially win in a settlement.
Things such as medical bills or lost wages are considered special damages, while emotional distress and suffering are general damages. These general damages are usually calculated at anywhere from 1.5 to 5 times the amount of special damages. Any precedent set by similar settlements and the savings of avoiding trial should all be calculated into what you and your attorney seek in your own settlement.
However, because a TBI may not be easily noticed like a bruise or a fracture, insurance companies will frequently try to lowball their settlement or outright refuse to pay. Internal injuries are frequently viewed this way by insurance companies because they assume that since they can’t see it, the person must be faking their injuries. Also, insurance companies will attempt to show that you are functioning at or near the same level you were before the injury. Every documentation of your abilities in all walks of life will be examined in order to do this. However, brain imaging technology has improved exponentially in the past decade, so objective evidence of traumatic brain injury is easier to obtain and prove. They will also try to contact you during your recovery in an attempt to show that the extent of your injuries is overstated. They can use something that is inane as an “I’m fine” response to the question of “How are you?” as evidence of your well-being.
Contact a Chula Vista San Diego Brain Injury Attorney
If you have sustained a traumatic brain injury due in Chula Vista to someone else’s negligence, don’t depend on insurance to offer a proper settlement. You’ll need an experienced Chula Vista San Diego brain injury attorney who knows the lasting damage a brain injury can cause, and who has the expertise to make sure insurance companies compensate for every penny owed.
