Presence of Mind

W. Bradley Parker
Protecting the rights of North Texas personal injury victims since 1985.

The Parker Law Firm

A traumatic brain injury (TBI) can cause bleeding or swelling and permanently damage nerve cells. Any time someone’s head is hit hard or violently jolted, serious brain injury can occur. Nearly 1.5 million people suffer from TBI each year, according to the Centers for Disease Control and Prevention (CDC). It’s no surprise that car accidents are a leading cause of TBI, but other common reasons include falls, sports injuries or military incidents.

In 2019, the CDC reported that falls accounted for 48 percent of TBI-related ER visits among those aged 65 and older. Motor vehicle accidents were the leading cause of hospitalizations for adolescents and adults aged 15–44 years of age. Persons aged 15–24 years and 75 years and older are at highest risk of sustaining a TBI, with the most common causes attributed to motor vehicle crashes, falls and violence.

Car Accidents, a Leading Cause

Trauma to the brain can occur during an automobile accident when the skull strikes, for example, an object like a steering wheel or windshield. But what is really scary is that the skull may not necessarily need to have been penetrated or fractured for a traumatic brain injury to occur. In many cases, the sheer force of the accident can cause the brain to collide against the internal hard bone of the skull because when a moving head comes to a quick stop, the brain continues in its movement, striking the interior of the skull. This can cause bruising of the brain and bleeding that may not be visible at the time of injury.

Brad says, “It’s imperative to always see a doctor if you have received a blow to the head that concerns you or causes behavioral changes. Seek emergency medical care if there are any signs or symptoms of traumatic brain injury following a recent blow to the head.”

There are ways in which drivers can greatly reduce the risk of experiencing a TBI. Vehicle operators and their passengers should always wear a seatbelt and ensure that small children are in the back seat and secured in a child safety or booster seat. Refraining from driving under the influence of alcohol or drugs decreases your chance for collision.

“Minor accidents don’t typically lead to severe brain injuries. Speed plays a major factor in how serious injuries are from a crash. Most of the time, a brain injury is associated with a loss of consciousness but not always,” Brad says. “That’s why it’s so important to seek medical attention immediately following an accident.”

Defining Severity

TBI severity typically classified as mild, moderate or severe. The severity of the injury is based on several factors including loss of consciousness, brain imaging, amnesia, or coma rating scale. Mild, moderate and severe TBI may be characterized as follows:

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Mild TBI

  • Brief loss of consciousness (seconds or minutes)
  • Post-traumatic amnesia for less than 1 hour following the injury
  • Brain imaging results with no signs of permanent damage

Moderate TBI

  • Loss of consciousness that lasts between one – 24 hours
  • Post-traumatic amnesia that lasts for one – 24 hours following the injury
  • Brain imaging results that show abnormalities

Severe TBI

  • Loss of consciousness or coma for more than 24 hours
  • Post-traumatic amnesia for more than 24 hours following the injury
  • Abnormal brain imaging results with signs of permanent damage
  • Severe traumatic brain injury can further be indicated by coma, vegetative state or minimally responsive state.

Health professionals use the Glasgow Coma Scale (GCS) to measure brain injury. The three areas of the test include: ability to speak, ability to open eyes, and ability to move. A score of 13 and higher indicates a mild TBI, 9 through 12 indicates a moderate TBI, and 8 or below indicates severe TBI.

Brad Parker says the severity of a traumatic brain injury has a dramatic bearing on a client’s case. “The more severe the injury, the more compensation the client deserves. With that said, a mild brain injury can be extremely serious and shouldn’t go overlooked. I’ve had clients experience anything from short-term memory loss and speech issues to coordination problems and light sensitivity. In more severe cases, the effects are quite profound. Clients must relearn how to feed themselves, walk and talk,” Brad says.

Contact Sports and Concussions

Sports-related injuries and explosive blasts/military combat injuries are other leading causes of TBI. Concern for young athletes has heightened over the last decade. All it takes is one tackle or improperly executed cheerleading flip to change your child’s life forever. Chronic Traumatic Encephalopathy (CTE) occurs among those who participate in high school contact sports and suffer repeated concussions.

Sports concussion law says…1) any athlete suspected of having sustained a concussion must immediately be removed from play; 2) the athlete may not be returned to action the same day; and 3) the athlete may be returned to action only after written clearance is provided by a licensed health-care professional.

Recognizing a Concussion

  • Can’t recall events prior to or after a hit or fall
  • Appears dazed or stunned
  • Moves clumsily
  • Answers questions slowly
  • Loses consciousness (even briefly)
  • Shows mood, behavior, or personality changes
  • Headache or “pressure” in head
  • Nausea or vomiting
  • Balance problems or dizziness, or double or blurry vision
  • Bothered by light or noise
  • Feeling sluggish, hazy, foggy, or groggy
  • Confusion, or concentration or memory problems

In addition to challenges with work or school and completing tasks that were once routine, a TBI can also affect a client’s personal life. Family relationships almost always change because the patient will be totally dependent on their caregivers. “A client’s family becomes so important in the case process when a traumatic brain injury has occurred. They are the ones that interact with the injured client on a daily basis, best understand and can communicate the details of the effects the injury has had upon the life of their loved one,” Brad says. No matter the cause, the truth of the situation is that most people with moderate to severe TBI face life challenges that will require them to adjust to a new reality.

Traumatic Brain Injury: Physical, Cognitive and Mental Repercussions

The specific long-term effects of a traumatic brain injury can be divided into several categories, including physical changes, motor deficits, cognitive effects, speech challenges, sensory effects, perceptual effects and social-emotional changes.

  • Sleep disorders
  • Loss of stamina
  • Loss or increase in appetite
  • Seizures
  • Difficulty swallowing
  • Physical paralysis
  • Hormonal changes
  • Chronic pain
  • Loss of control of bowel and bladder functions
  • Muscle stiffness
  • Uncontrolled movements
  • Problems walking or talking
  • Difficulty carrying or moving objects
  • Loss of fine motor skills
  • Difficulty with attention, focus or concentration 
  • Slow speed of processing
  • Confusion
  • Impulsiveness
  • Problems with planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions, and inhibiting inappropriate actions
  • Slurred speech
  • Difficulty with talking, understanding language, and with reading and writing
  • Speaking very fast or very slow
  • Difficulty perceiving movement of the arms and legs
  • Difficulty understanding information taken in through the senses 
  • Partial or total vision loss
  • Blurred or double vision
  • Problems judging distance
  • Light sensitivity or intolerance
  • Decrease or loss of hearing
  • Tinnitus (ringing in the ears)
  • Sensitivity or intolerance to sounds 
  • Diminished sense of smell
  • Loss or diminished sense of taste
  • Lack of inhibition
  • Dependent behaviors
  • Depression
  • Lack of motivation
  • Irritability and/or aggression

At Parker Law Firm, our experienced personal injury lawyers believe people matter. We are committed to our clients, not case numbers, and we believe in the power of the civil justice system. With years spent both representing accident victims and participating in the state legislative process, our founder, Brad Parker, has developed a deep understanding of the law and gained unique experience that helps him get results for his clients.

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