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Millions of people every year are victims of some level of a traumatic brain injury. Some aren’t very bad relatively speaking as no brain injury is good, but the mild ones rarely require hospitalization. More severe ones do, however, and some are, quite simply put, fatal. Fortunately, out of the millions affected by a Traumatic Brain Injury (TBI) every year, the number of fatalities is very small. That leaves millions who are affected and require some level of recovery and rehabilitation in order to be reintegrated into society. For those who have suffered a Traumatic Brain Injury (TBI), and for the friends and family around them, knowing what to expect and how recovery will progress is something they want to know. The severity of the injury is the single biggest factor. The prior health and functions of the survivor will also impact recovery. Any pre-existing conditions, and the health conditions and strength of the victim before the injury occurred, are all factors which will impact recovery.

The worst state is when the victim is effectively brain dead. The body is still alive, but there is no brain activity and in order to keep the body alive, artificial means are required. The removal of the life support equipment would result in all cessation of other life sustaining functions. This condition will not improve.

The next state is almost as severe, but not quite. If the injury is severe, then it is expected that the victim will probably be in some form of a coma, or a state where the body is alive, but unaware of stimulus. This state is often the case when the brain is still showing signs of activity however the body may still require artificial means to maintain life. This condition may improve, but the odds of recovery decrease as time progresses. If conditions improve within the first one to three months, odds of some form of recovery are quite good. However, if the vegetative condition persists for longer than a year, then the odds decrease dramatically.

For patients who are aware and are sustaining consistent awake/sleep cycles, the diagnosis of how much damage has occurred will be based on tests to determine how much the various skills have been affected by the injury. From basic motor skills, through vision and hearing tests, and following up to concentration and attention skills, doctors and diagnosticians will see if any other lower functions are affected. After that, language skills, spatial and constructional abilities and memory skills are studied for any deficiencies. Lastly, reasoning skills, intellectual abilities and academic abilities are tested for both pre and post injury retention and capacity.

Once all of these tests are run, the doctors, diagnosticians and specialists will sit down, come up with a “map” of the severity and scope of the injuries and set down a course of rehabilitation and therapy for the victim to recover as much of their abilities as possible. While a full recovery may not be possible, the quality of life for the victim can usually be improved greatly through drug, psychological and physical therapy. Also, having an attorney who is familiar with traumatic brain injuries involve ensures the victim is getting the full attention they deserve and need in order to recover as fully as possible.
]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=20 Wed, 2 Jul 2008 15:00:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=19 Concussions are the most suffered Mild Traumatic Brain Injuries (MTBI) and can cause persistent headaches, trouble remembering things, concentrating or making decisions. Also, a concussion can have lingering effects such as a tired feeling, sadness, listlessness or anxiousness. Other effects can include becoming irritated or angry for little or no apparent reason. Signs of concussion vary between adults and children, and a popular misconception is that the victim has to lose consciousness to have suffered a concussion. This is not true. It is possible to have a concussion and not be knocked out, although those cases are usually not as severe as other types.

Warning signs of a concussion in adults are as follows: a headache that gets worse, weakness, numbness or decreased coordination, repeated vomiting. Other warning signs are that the victim falls asleep and cannot be awakened, has one pupil where the lens, or the black part in the center, is larger than the other, the victim may have convulsions or seizures, may have slurred speech and may get more and more confused, agitated or restless. The danger signs for children include all the signs for adults and infants and toddlers may not nurse, can’t stop crying and may be inconsolable.

Recovering from a concussion is a lot like recovering from most injuries. Resting gives the brain time to heal. Taking the time necessary to recover is important. Depending on the severity of the concussion and the location of the part of the brain that was injured will also affect the amount of time it’ll take to recover. Other factors that can delay recovery are if the body has other injuries or medical conditions prior to the concussion, and if there have been other concussions prior to the current one.

Aside from getting plenty of rest at night, and resting during the day, victims of a concussion don’t need to return to their daily routine at once. Slowly adding activities back to their schedule and especially avoiding activities that could result in another brain injury are necessary. Since a concussion may well affect coordination and reflexes, it is important to get a doctor to assess whether or not the victim can return to driving.

Other things to keep in mind that may make the victim’s life easer are to have them write things down if they have problems remembering, and if they’ve exhibited problems with decision making abilities and with concentration, to have them consult with others before making an important decision and doing one thing at a time until it is completed.

While concussions do constitute a traumatic brain injury, since they are closed skull injuries, sometimes it is difficult to gauge the amount of time it will take to recover from it. Be sure to discuss with an attorney and your health care professionals about doing things such as returning to work, and what other detrimental effects a Mild Traumatic Brain Injury (MTBI) can have on the victim’s life.]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=19 Thu, 26 Jun 2008 14:35:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=18 If there is a lot of blood and a broken skull, understanding that someone has a traumatic brain injury is fairly easy. Medical professionals busily try to stem the bleeding, and to heal the body. It can be markedly different when the injury isn’t as readily apparent, such as when there is a closed skull injury. Some people have difficulty accepting the fact that a traumatic brain injury has actually occurred unless the patient is unconscious. If a patient is unconscious, then it becomes a matter of determining just how bad is the Traumatic Brain Injury (TBI). The longer the person is unconscious, typically the worse the Traumatic Brain Injury (TBI). Determining the extent and scope of the damage has to wait until the patients regain consciousness before a complete evaluation can be made. Only when the neuropsychological tests are performed can the professional diagnose which areas of the brain are affected by the injury.

MRI’s and CAT scans can be used to see how much physical damage occurred. Vision tests can determine whether the parietal lobes are affected, memory tests assess frontal lobe injuries, motor skills test for the back and brain injury. Psychological and other physiological tests are used to determine how deeply the brain has been affected by the injury. Only after several exhaustive batteries of tests have been run to gauge the extent of the injury can specialized treatment and rehabilitation begin. Even then, the families of the victims need to be informed of the changes they can expect because of the injuries.

When someone shatters a leg or an arm and it is in a cast or is missing, the injury is readily apparent and it is easy for other people to understand that there is an injury. Having others understand that someone who has suffered a mild to moderate brain injury is more difficult even though the injury will have significant changes in a person’s life, because outwardly, there appears to be no obvious injury. Brain injury survivors do not wear a sign that says they have been injured but they need everyone’s patience just as much as others with debilitating injuries. Survivors and the caregivers of those with Traumatic Brain Injuries (TBI) will benefit from listening to the health care professionals and doing the research to understand the effects of a Traumatic Brain Injury (TBI). Victims of a Traumatic Brain Injury (TBI) of this nature may or may not understand that their injury is as impactful on their lives as it can be, so getting as much understanding into the scenario as possible is always beneficial.

Ensuring the victim is getting all the tests they need for a complete evaluation and then getting the victim the best care and treatment available is essential so they can have the best quality of life after a Traumatic Brain Injury (TBI). Having people around you like health care providers and attorneys that specialize in Traumatic Brain Injury (TBI) cases gives the victim of a Traumatic Brain Injury (TBI) the best possible chance for the best possible life.
]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=18 Thu, 19 Jun 2008 14:29:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=17
Damage to the part of the brain that controls our eye muscles can cause several different conditions such as double vision or eyestrain. Double vision occurs when the eyes don’t track the same point at the same time due to a misalignment in the muscles. This may be constant, but also may be intermittent as well, depending on the injury, and may be positional in nature. For instance, the patient may be fine when looking straight ahead, but when moving the eyes to the side, the doubled vision may manifest itself. Also, when reading the eyes track together to move from word to word, and damage to muscular control may impair this tracking, causing eyestrain, headaches and even an impairment in the ability to read.

Light sensitivity may also result from a Traumatic Brain Injury (TBI). Like the volume control on a stereo, the eyes automatically adjust to the amount of ambient light in an area, and when this is affected by injury, the eyes either adjust slowly or not at all, which means the patient has difficulty in transitioning from one area to another in terms of light level. This is most often the case when moving from a low-light area to a high light area, such as moving from an indoor room to outside, on a sunny day.

Dry eyes are also a possible effect from a Traumatic Brain Injury (TBI). This means the eyes feel dry or gritty, and may have a burning sensation. There are a variety of possible injury causes, but the net problem may stem from a reduction in the amount of tears produced, an inability to close the eyelids properly or a reduction in the blink rate which all results in a reduced ability to hydrate the eyes with tears.

One aspect of a Traumatic Brain Injury (TBI) may be a visual hallucination which can be very difficult to resolve. Usually manifested as a misrepresentation of objects or people as flashes of light, stars or flickering distortions, which prevents the victim from being able to properly form the actual image and recognize the object or person.

The last aspect to cover here is impaired visual memory. This simply means that the Traumatic Brain Injury (TBI) has affected the area of the brain which deals with recognition of objects and the resultant is that patients are no longer able to recognize objects, faces or certain letters.

Due to the nature of brain injuries, it is difficult to ascertain the exact nature of the extent of the damage. Quite often, a medical professional who is trained in both low vision and brain injuries is required to develop a rehabilitation plan to best serve the patient. Again, having an attorney who understand the needs of a Traumatic Brain Injury (TBI) victim will help ensure they are able to achieve the best quality of life after an injury as possible.
]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=17 Thu, 12 Jun 2008 14:08:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=16
In short, visual field loss means that there is a loss of ability to see from side to side. Generally, this type of loss occurs in both eyes, but due to the nature of the injury to the back of the brain, patients may mistakenly feel that the loss is only in one eye, since an injury to one side affects the opposite side in both eyes. This means that patients may bump into objects outside their field of vision, and may become startled by items and people that suddenly “appear” in front of them. Also, this type of injury may lead to enough difficulties, especially in crowded conditions such as stores, that they may develop a fear of leaving the home, and may even miss words and have difficulty reading.

Another effect may be in spatial recognition. This may manifest as a condition called “visual neglect” which means that a victim fails to appreciate space on one side. As an example, a male patient may no longer shave one side of his face, as the other side isn’t “seen”. Other spatial disorders may include the inability to navigate areas, even those that are familiar to them, may confuse left and right, and may have difficulty with depth perception and may misjudge straight ahead positioning. Due to the nature of the injury, visual neglect and visual field loss often occur together, compounding the issue.

TBI may induce a condition called nystagmus, which is a jerky movement of the eye. The net effect of this is that when the head moves to track an object or to read, the inner ear senses the change in angle and causes the eyes to move to compensate. When eyes move smoothly, everything stays in balance, but when the eyes move jerkily; this may cause a vertigo-like sensation or the sensation that the world is moving. Also, damage to the brain stem may also cause dizziness.

Since the back part of the brain has the most to deal with visual perception and control, any injury to this area can have a major effect. Only a few of the effects are discussed here, and others will be discussed in a second article. Regardless of the nature of a Traumatic Brain Injury (TBI), having an attorney who specializes in this type of case is of paramount importance to ensure that the patient’s rights are being taken care of properly.
]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=16 Thu, 5 Jun 2008 14:07:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=15
TWO. The next state is called a Stupor, and means that while a patient is unconscious, they do respond to light and to sharp stimuli like pain. Most patients in this state do recover some loss of function from this state and progress to some level of functional living.

THREE. A Coma is an unresponsive state where the patient does not respond to light or to external stimulus, including pain. Another sign of a coma is that the patient does not have sleep-wake cycles. Patients who are in a coma have suffered widespread trauma to the brain usually encompassing both the upper brain and lower brain and brainstem areas. A comatose state usually lasts from a few days to a few weeks, and then will change state. After this period, either a patient begins to gradually awaken, or the condition degrades into a vegetative state or into death.

FOUR. A vegetative state is described as a condition where a patient is still unconscious and unaware of their surroundings, but does have a sleep –wake cycle. Patients in this condition can actually have some level of alertness, and may even open their eyes, moan and groan, and have some reflexive responses to stimuli. This state is usually caused by damage to the upper brain and cerebellum while there is little or no damage to the lower brain or brainstem.

FIVE. Patients who do not emerge from a vegetative state within 30 days are said to be in a Persistent Vegetative State (PVS). Recovery from a Persistent Vegetative State (PVS) within the first six months is possible, with the chances for adults in the 50 per cent range, and 60 per cent for children. The chances of emerging from a Persistent Vegetative State (PVS) for those who remain in Persistent Vegetative State (PVS) for over a year are minimal at best, and those who do emerge have severe disabilities. The longer a patient is in Persistent Vegetative State (PVS), the more severe the disabilities will be. Rehabilitation can improve conditions, but most Persistent Vegetative State (PVS) patients are almost never able to take care of themselves.

SIX. The converse condition to Persistent Vegetative State (PVS) is called Locked-In Syndrome. This condition results when there is significant damage to the lower brain and/or brain stem resulting in the inability to move. This condition means that the patient is fully awake and aware of their surroundings, and able to communicate via eye movements and blinks, but is unable to move or function otherwise.

SEVEN. The last state is termed Brain Death which is the condition where there is no brain activity and the ability for the body to survive without mechanical assistance isn’t possible. Damage in these cases is usually extremely widespread across all areas of the brain, and there is no possibility of recovery.

This gives a quick overview of the states of brain damage, and an idea of what can be expected in each state. Keep in mind that each patient is an individual case, and that there are few ‘hard and fast’ rules with brain injuries. More information is best obtained from your health care professional.]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=15 Wed, 28 May 2008 14:00:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=14
One study involved men who were in World War II who were required to be hospitalized with non-penetrating head injuries or with other unrelated injuries. The ones who were in the hospital for non-head injuries were used as a baseline to gauge the extent of additional risk of dementia and Alzheimer’s Disease (AD) in those who did have head injuries.

This study showed a statistically significant correlation between head trauma and the occurrence of Alzheimer’s Disease (AD) and dementia. The study found that those who had sustained some type of moderate to severe head injury were at significant risk of developing some type of Alzheimer’s Disease (AD) or dementia later in life. Moderate head injury victims were about 2.3 times as likely as a person that had suffered no head injury to be diagnosed with Alzheimer’s Disease (AD) or dementia. Most notably, those who had some form of severe brain injury were almost four and one half times more likely to have a diagnosis of dementia or Alzheimer’s Disease (AD). This study was not geared to find a correlation between mild Traumatic Brain Injury (TBI) and Alzheimer’s Disease (AD) and dementia.

However, other studies have shown a correlation between mild Traumatic Brain Injury (TBI) and Alzheimer’s Disease (AD) and dementia. The correlation may be even greater than this one study shows because of all the undiagnosed traumatic brain injuries that occur each year. The medical professionals who are involved in clinical settings have lots of anecdotal proof of the relationship between even mild Traumatic Brain Injury (TBI) and Alzheimer’s Disease (AD) and dementia.

This study suggests that if the injury occurs later in life, then there is almost 1:1 correlation of evidence hastening the onset of AD, or Alzheimer’s Disease symptoms and dementia.

Anytime one is coping with a brain injury the possibility for Alzheimer’s Disease (AD) or dementia must be watched and considered as part of the injury. The causes of Alzheimer’s Disease (AD) are still being studied. Medical science agrees that there is no one sole cause for Alzheimer’s Disease (AD). However, is appears from the study that suffering a Traumatic Brain Injury (TBI) is one of the factors that substantially increases the likelihood of being diagnosed with Alzheimer’s Disease (AD) and dementia.]]> Brain Injury Medical Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=14 Wed, 21 May 2008 13:57:32 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=13
However, in “modern times”, the first real documented studies of someone with a traumatic brain injury that survived their injuries were about Phineas Gage.
On September 13, 1848, Phineas Gage received an injury that by all rights should have killed him. As the foreman of a blasting crew for the railroad, it was Phineas Gage’s job to pour and set the charges to blast away rock and mountain so rail line could be run. This meant that after a hole was drilled, he would pour in powder and sand and lay in a fuse, then tamp down the mix with rock to control the blast. It isn’t clear as to what caused the explosion that injured Mr. Gage, whether it was a stray spark that set off the gunpowder, or if the sand was omitted, which meant the rock was right against the gunpowder when he began tamping, but the end result was clear. An explosion occurred which blew the 1 ¼” diameter tamping iron through Mr. Gage’s lower jaw, behind his left eye, and then exited through his temple, landing some 60 to 80 feet away.

Remarkably, Mr. Gage survived. He was talking coherently, and even walking within minutes of the injury. He sat upright in the cart on the way into town to seek medical assistance. When he arrived in town to the doctor, aside from being weak from blood loss, he seemed relatively normal. The initial examination showed that his left pupil was responsive to light, which meant that the rod had missed his optic nerve, and since he hadn’t bled to death, the major arteries in the brain were also missed.
Given the limitations of the medical field at the time, Mr. Gage’s recovery was what could be termed ‘typical’. He acquired an infection, which could’ve been from debris, or from the tamping rod itself, and spent almost a month in a semi-comatose state. After that, aside from a fever about a month later, his recovery progressed well, until in the middle of 1849, he felt well enough to return to work.

Before the injury, Phineas Gage was the most capable and efficient foreman that the railroad company reportedly had. He had a well-balanced mind and was admired for his business smarts. After the injury and recovery, he displayed irritability, fitfulness, Tourette’s –like symptoms, and was unable to plan or to execute plans. Mild-mannered Phineas Gage had turned irreverent and grossly profane, showing little regard for his co-workers or fellow citizens. He became impatient, difficult to deal with and could not stay focused. As his friends stated, he was “no longer Gage”.

Phineas Gage died outside of San Francisco, California on May 21, 1860. A transformation from mild-mannered businessman Phineas Gage to the more reckless and insensitive brain injury survivor was the first well-documented effect that a traumatic brain injury could have on a person’s brain function and emotional wellbeing. Phineas Gage is often attributed to be the father of modern brain injury research.


Perry Fisher Brain Injury Attorney Copyright 2008.]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=13 Tue, 6 May 2008 14:03:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=12
The Temporal Lobes are located on either side of the head just above the ears. These lobes contain the functions for hearing and for memory acquisition. The temporal lobes also share responsibility for visual perception, and categorization of objects. When damaged, victims of temporal lobe injuries exhibit a wide variety of symptoms including difficulty in recognizing faces and difficulty in understanding spoken words. Injured victims also experience a disturbance with selective attention to what they see and hear and difficulty with identification of, and verbalization about objects. Other exhibited symptoms include: short-term memory loss, interference with long-term memory, marked increased or decreased interest in sexual behavior and the inability to categorize objects. Right lobe damage can cause persistent talking and also an increase in aggressive behavior.

After extensive study, scientists have determined there are eight principle symptoms which can indicate temporal lobe damage:
1) disruption of auditory sensation and perception
2) disturbance of selective attention of auditory and visual input
3) disorders of visual perception
4) impaired organization and categorization of verbal material
5) disturbance of language comprehension
6) impaired long-term memory
7) altered personality and affective behavior
8) altered sexual behavior

While damage to other lobes of the brain may exhibit similar symptoms, especially with the altered personality and sexual behavior, symptoms pertaining specifically to hearing are essentially temporal lobe injuries.
Since speech may also be affected by a temporal lobe injury, studies have been done on patients who have managed to recover some or all of their speech center functionality. Researchers have been pleased to discover that some patients experience brain plasticity effects. Scientists are still studying why some people can partially rewire their brains and regain some small level of increased function and others cannot. There are even studies that victims of a temporal lobe injury may experience a reorganization of the neural paths that re-enables some speech usage by a victim.

While this doesn’t hold true for all affected functions of a victim of a temporal or occipital lobe TBI, it does show that sometimes the brain has some type of recovery system in place to help compensate for the losses of an injury.


Brain Injury Attorney Perry Fisher Copyright 2008.]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=12 Wed, 30 Apr 2008 13:51:00 -0400 http://www.braininjurync.com/brain-injury-blog/index.php?itemid=10 Traumatic Brain Injury (TBI) to the frontal lobes of the brain can wreak havoc with many important brain functions. The frontal lobes are mostly responsible for who a person is, although there are some motor function involvement as well. According to studies, as well as motor functions, the frontal lobes are involved in problem solving, language, memory, initiation, social and sexual behavior, impulse control, executive functions and judgment. Due to a Traumatic Brain Injury (TBI), a person’s social interactive behavior can change drastically, which can include signs of depression or psychopathic tendencies, a change in a person’s risk taking judgment, abnormal or decreased sexual behavior, and may even affect behavioral spontaneity.

These studies further define that the left frontal lobe deals generally with language functions and the right side generally deals more with non-verbal movements, although this is not a hard and fast rule, as some research has shown that both sides are involved with all functions in most people.

However, since language function and motor control are contained within the frontal lobe, this means that in many cases a TBI to this area can have a major impact on a victim’s life. Facial muscle control and the speech center is also controlled from the frontal lobes, which means that damage, especially to the left frontal lobe can impair the ability to utilize words, or if the primary damage is to the right lobe, this may prevent the victim from being able to control the muscles in the face required to form words. In either case, or if the damage is consistent in both lobes, a victim’s ability to communicate could be severely compromised. A Traumatic Brain Injury (TBI) to the frontal lobe also seems to affect spatial orientation as well, which coupled with the affects to motor control can impair hand-eye coordination to a significant degree.

One interesting phenomenon of frontal lobe damage is the fact that a victim’s IQ is rarely affected. While a victim may not be able to reason effectively, or to express himself due to the inability to form or use words properly, the intelligence behind it is largely unaffected. Scientists have come to believe this is because IQ is a result of Convergent processing as opposed to Divergent processing. Frontal lobe damage seems to affect divergent, or reasoning and flexibility in decision making and planning skills. Evidence also shows that there is a certain level of memory and attention interference even after a good recovery from a Traumatic Brain Injury (TBI).

While seemingly less physically debilitating as a lower brain injury, even a mild Traumatic Brain Injury (TBI) to the frontal lobes can have deeper and more profound effects on a victim’s life than might first appear to the injured persons friends and family.

Perry Fisher Copyright 2008.
]]> Brain Injury Legal Information http://www.braininjurync.com/brain-injury-blog/index.php?itemid=10 Wed, 23 Apr 2008 12:48:52 -0400