Traumatic Brain Injuries vs. Concussions

By Premier Law Group’s consulting RN

Having represented hundreds of personal injury cases in the Seattle area, the attorneys at Premier Law Group have witnessed first-hand the life-long consequences of head injuries including traumatic brain injuries and concussions for victims as well as their family and friends. Below is information to help identify if you or a loved one have experienced a brain injury, what to expect, and how to move forward.

Understanding the Difference

The Center for Disease Control (CDC) defines a traumatic brain injury (TBI), as a “bump, blow, or jolt to the head that disrupts the normal function of the brain.” A concussion is a mild type of traumatic brain injury. According to the CDC’s statistics, there were approximately 2.87 million TBI-related emergency department visits, hospitalizations, and deaths in the United States during 2014. There are even more incidents of concussions. Since symptoms are often not evident, many people do not seek medical attention after the trauma.

Mechanisms of Injury (how the injury occurs)

motor vehicle collision slip and fall injury Assault Domestic abuse

• Motor vehicle collisions
Injuries can occur by the head physically hitting against an object, or the brain being shaken significantly back and forth as it hits against the skull (whiplash). In car accidents, the injuries can occur with rapid acceleration and deceleration (the same mechanism seen in “shaken baby syndrome”).

• Falls
• Intentional self-harm
• Assault/domestic abuse

• Sports
Significant and repetitive concussions can occur in contact sports such as football, soccer, and rugby. Even without physical contact with other athletes, injuries can happen when objects, such as a baseball or football, are thrown and hit the head.

• Military combat
Head injuries can occur from explosions, flying debris, etc.

 

 

What causes short-term or long-term problems?

Neuron Brain CellAxon Injury

  • An axon, or nerve fiber, is a long slender projection of a nerve cell, or neuron, that sends a signal or information in a nerve impulse to tell the body to do something.
  • An injury to the axon could be temporary and more likely be swelling. An example would be if you turned your ankle the wrong way, and the swelling went down to return to normal movement.
  • In a more significant injury, the axon can be broken.

 

Secondary Source

A secondary source can cause swelling and decreased oxygen to the brain. This would occur due to molecular changes in electrolytes and vasculature which are experienced when other areas of the body undergo trauma. When the brain is injured through some type of external force, symptom(s) such as the ones listed below will be noticed. These symptoms may go away when the swelling goes down, or there may already be damage beyond repair.

Delayed or abnormal verbal responsesDelayed or abnormal ability to follow commands
Loss of consciousnessConfusion
Memory loss (immediate or lingering later)Headache
DizzinessNausea/vomiting
Exhaustion/tirednessTrouble sleeping
Crankiness/irritability/mood changes (psychiatric consult may be necessary in this situation to continue care if long-term problems arise)Vision changes; vision loss in a certain field (*one eye; certain areas of the field of vision); light sensitivity
Seizure*Weakness on one side of the body
Pupil change (*one pupil differing in size or shape compared to the other)

brain hemorrhage

Treatments/Medical Assessment

CT Scan/MRI

Most emergency rooms complete a CT scan quickly when someone presents to the emergency room after head trauma while on a blood thinner, since they are at higher risk for injury.

  • Normal CT scan

A CT scan may appear normal with a mild TBI/concussion. If the CT scan presents normal, and a medical provider has further concern about an injured person’s symptoms, an MRI may be ordered as another test for clearance of significant injury to the brain. An MRI is a more detailed image of the brain, but it takes longer to complete.

  • Bleeding

If bleeding is noted on a radiology scan that would indicate an intervention like surgical decompression. Many people who have bleeding on the brain are observed in the hospital closely, to see if the body resolves the injury itself.

  • Other CT abnormalities

These can include swelling of the brain or fluid shifts to a certain side. These injuries demand more intensive treatment in an ICU. Many medications are utilized to lower the pressure inside the head to let the brain rest and recover.

  • Repeat CT scan

Another scan may be repeated if symptoms worsen, or if there is a new symptom onset, since there may be delayed bleeding after initial evaluation.

  • Medication and rest

Whether an abnormality is noted on the CT/MRI or not, it is important that the injured person rests and takes medication as recommended by medical provider (i.e., medications for nausea, pain, seizures).

The medical provider may feel that the risk of radiation from the CT scan is not worth the mechanism or symptom that the injured person has experienced.  In this case, the injured person will be instructed to have a family member or friend monitor them closely to make sure symptoms resolve and do not get worse.

Long-term Problems Related to Traumatic Brain Injuries

Even without initial symptoms, it is important that the victim of a significant head trauma have eye, face, and neck evaluations by a qualified practitioner. The close proximity of these parts, and the mechanism of how the person has been injured, can indicate further injury to other areas of the body that should not be ignored. The initial rush of adrenaline often distracts the person from being attentive to other injuries that may present complications later.

  • Encephalopathy

A more serious TBI could cause chronic traumatic encephalopathy, which includes ongoing problems with memory, behavior, speech, and personality changes. The person who experiences this complication from a head injury may exhibit symptoms seen in Parkinson’s disease (i.e., shuffling while walking, tremors).

  • Epilepsy / Seizures

Another more debilitating complication from a TBI can be long-term seizures (epilepsy). A person who experiences a seizure directly after a head injury is 25% more likely to bear this complication long-term (Evans, 2019). Seizures are a condition that seriously affect a person’s way of life and may require changes in transportation, work (way of income), cooking, and living situation (if they lived alone prior to the accident).

  • Chronic Symptoms

There are many symptoms that can become long-term complications of a traumatic brain injury such as headaches, sleep disturbances, dizziness, and psychological disorders (i.e., depression, anxiety, personality changes). Management of these symptoms could become chronic, and the treatment can involve many medical disciplines. If the changes are significant enough, a consistent caretaker may need to be involved in the person’s life.

Understanding your Rights

No matter how your head trauma occurred, you should seek medical attention and then contact an attorney. At Premier Law Group, we understand the serious consequences of a TBI and work to protect the rights of people dealing with these devastating injuries. Our attorneys, who specialize in brain injury cases, recognize that the medical costs, physical pain, and emotional suffering of a head trauma can dramatically affect the lifestyle and work of the person injured and their family. PLG’s mission is to help relieve some of the stress by fighting for just compensation, so victims and their loved ones can focus on recovery and rebuilding their lives.

We encourage you to talk with one of our award-winning attorneys who can answer your questions and provide guidance about next steps.  Please call us at 206-285-1743 for a free consultation.

 

References:

Connor, K. (2018, July 11). Why are Neuron Axons Long and Spindly? Retrieved April 7, 2020, from https://ucsdnews.ucsd.edu/pressrelease/why_are_neuron_axons_long_and_spindly

Evans, R. W., & Wilterdink, J. L. (2018, August 22). Postconcussion syndrome. Retrieved April 7, 2020, from https://www.uptodate.com/contents/postconcussion-syndrome?search=concussion&topicRef=4828&source=see_link

Evans, R. W., & Whitlow, C. T. (2019, April 8). Acute mild traumatic brain injury (concussion) in adults. Retrieved April 7, 2020, from https://www.uptodate.com/contents/acute-mild-traumatic-brain-injury-concussion-in-adults?search=concussion&source=search_result&selectedTitle=1~75&usage_type=default&display_rank=1

Fall Prevention Don’t Become A Victim. (n.d.). Retrieved April 7, 2020, from http://www.mysafecalifornia.org/fall-prevention/

Karnaukh, M., & Coalson, R. (2019, November 20). New Push to Pass Domestic-Violence Law Angers Russia’s ‘Traditional Values’ Conservatives. Retrieved April 7, 2020, from https://www.rferl.org/a/russia-domestic-violence-law-traditional-values-conservatives/30283060.html

McKee, A. C., Cantu, R. C., Nowinski, C. J., Hedley-Whyte, E. T., Gavett, B. E., Budson, A. E., … Stern, R. A. (2009). Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. PubMed. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed?term=19535999

Milanovich, M. (n.d.). Brain Surgery Infographic. Retrieved April 7, 2020, from https://infograph.venngage.com/p/185448/brain-surgery-infographic

Patient education: Concussion in adults (The Basics). (n.d.). Retrieved April 7, 2020, from https://www.uptodate.com/contents/concussion-in-adults-the-basics?search=concussion&topicRef=4828&source=see_link

Rajajee, V., & Wilterdink, J. L. (2018, July 18). Traumatic brain injury: Epidemiology, classification, and pathophysiology. Retrieved April 7, 2020, from https://www.uptodate.com/contents/traumatic-brain-injury-epidemiology-classification-and-pathophysiology?search=contrecoup injury&topicRef=4828&source=see_link

TBI: Get the Facts. (2019, March 11). Retrieved April 7, 2020, from https://www.cdc.gov/traumaticbraininjury/get_the_facts.html

Traumatic brain injuries guide. (n.d.). Retrieved April 7, 2020, from http://traumaticbraininjuriesguide.com/all-you-want-know-about-car-accident-tbis/

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