Brain Injuries from Car Accidents

Approximately 4.5 million people were seriously injured in car accidents in 2018, according to a report by the National Safety Council. Of these many car accident injuries, those affecting the brain are some of the most devastating. When an accident occurs, drivers and passengers travelling at high speeds can receive a blow to the head as the vehicle suddenly stops or changes direction. This sudden impact may result in a traumatic brain injury (TBI) which can have effects ranging from a mild concussion to a coma with lifelong consequences.

What Is a Traumatic Brain Injury?

As defined by Mayfield Clinic, a TBI is “an injury to the brain caused by a blow or jolt to the head from blunt or penetrating trauma.” The injury is generally broken down into primary and secondary injuries. The primary injury happens at the time of the initial impact. This impact causes the soft brain to collide with the rough interior of the skull, potentially doing damage to certain lobes or even the entire brain. Depending on the severity of the initial impact, a person could appear to be fine. However, the brain may continue to undergo a delayed trauma in which it swells and pushes against the skull’s interior, reducing the flow of oxygen-rich blood; this is the secondary injury.

Symptoms of a traumatic brain injury include:

• Loss of consciousness
• Confusion/ disorientation
• Headache
• Fatigue
• Memory loss
• Poor concentration
• Irritability
• Dizziness
• Seizures

If you are experiencing any of these symptoms following a car accident, seek medical attention for a physical examination. Symptoms will vary from patient to patient as every head injury is different. A diffuse injury (e.g. concussion or diffuse axonal injury) will typically cause a general decreased level of consciousness. Focal injuries (e.g. intracerebral hemorrhage or contusion) will result in symptoms that vary depending on the affected area of the brain.

Types of Traumatic Brain Injuries

According to Northeastern University, a TBI can be categorized as open or closed. An open TBI occurs when the skull is fractured or penetrated by a foreign object, damaging the brain. A closed TBI is more common in the case of a car accident. Closed TBI occur when there is a blow to the head, but the skull does not break. Symptoms of an open versus a closed TBI can vary.

Depending on the severity of your primary injury, you can sustain a number of different types of traumatic brain injuries. If you sustained a TBI as a result of a car accident, you may even be suffering from more than one type of TBI. The Mayfield Clinic provides detailed information on the following types of TBIs:

• Concussion
  A concussion is a generally mild TBI that may temporarily cause confusion, issues with memory, speech, vision, or balance. This injury is one of the most common TBI and is treated by allowing the brain time to rest. However, if left untreated a concussion can leave a patient with life-long damage.
• Diffuse Axonal Injury (DAI)
  A diffuse axonal injury occurs when the brain violently moves back and forth in the skull, causing the nerve axons to tear. Axons are responsible for connecting nerve cells throughout the brain. Extensive tears in the connections throughout the brain can cause variable degrees of damage and can even be fatal. Symptoms will depend on the affected areas of the brain.
• Contusion
  A contusion is a bruise, a form of bleeding beneath the skin that is caused by a blow to the head. These commonly occur in conjunction with concussions. If the bleeding does not stop on its own, surgery may be required. The severity of a contusion depends on its location in the brain, the size of the bleed, and the length of time it lasts.
• Traumatic Subarachnoid Hemorrhage (TSAH)
  Traumatic Subarachnoid Hemorrhage is bleeding that happens in the space surrounding the brain. This space should be filled with cerebrospinal fluid, acting as a cushion between the brain and skull. This injury occurs during the primary injury when small arteries tear causing blood to flow over the brain. This blood irritates the brain, increases pressure on the brain, and causes damage to brain cells. Additionally, the area to which the torn arteries usually carry blood is now deprived of necessary oxygen-rich blood, causing widespread negative effects.
• Coup-Contrecoup Brain Injury
  A coup-countercoup injury occurs when an impact to the head causes the brain to hit into the opposite side of the site of impact. There is damage both at the site of impact as well as the opposite side of the brain. This type of injury is usually more violent with immediate effects. Because this injury is generally more severe, patients may need extensive treatment to recover.
• Hematoma
  A hematoma occurs when a blood vessel ruptures, and the escaping blood begins to clot as the body naturally attempts to close off the bleeding. A hematoma can vary in size; a large hematoma can be dangerous as the clot puts pressure on the brain. Symptoms resulting from a hematoma vary depending on the site of the blood clot. Large hematomas may require surgery to be removed.

How Severe is a TBI?

When assessing the severity of a TBI, medical examiners commonly use the Glasgow Coma Scale (GCS). This scale ranges from 3 to 15 points and determines whether a TBI injury is mild, moderate, or severe. Three aspects are given a score, a lower score indicates a more serious injury. Doctors score the following:

• Patient’s ability to open their eyes
• Ability to respond appropriately to questions
  • E.g. “What is your name?” or “What is today’s date?”
• Ability to follow commands
  • E.g. “Hold up two fingers.”

Depending on how the patient does with each of the three tests, they are given a score of 3 to 15. The scores classify the severity of a TBI injury as follows:

• Mild: 13 to 15
• Moderate: 9 to 12
• Severe: 8 and below

A patient experiencing a severe TBI will need extensive treatment. Before a doctor is able to prescribe the correct treatment, they will need to diagnose the exact type of injury.

Diagnosing a Traumatic Brain Injury

Because symptoms from TBIs can vary so greatly, it is difficult for a doctor to form a proper diagnosis without conducting the proper tests. The following tests are commonly used individually or in combination to diagnose TBIs:

• Computerized Tomography (CT): uses a series of X-rays to produce a detailed image of structures in the brain. A Ct scan is usually taken at the time of the injury to quickly detect fractures, bleeding in the brain, hematomas, etc. CT scans may be taken throughout the course of treatment to guide decisions on the patient’s care.
• Magnetic Resonance Imaging (MRI): uses magnetic field and radiofrequency waves to create a detailed image of soft tissues in the brain. This test is able to show subtle details that cannot be seen in a CT scan. More detail can be achieved by injecting the patient with a dye (contrast) before the test.
• Magnetic Resonance Spectroscopy (MRS): using the same machine as an MRI, a spectroscopy is a series of tests done to gather information on the metabolism of the brain. This information provides a general prognosis on the patient’s ability to recover from the injury.
• Intracranial Pressure (ICP) Monitoring: a probe is inserted through the skull in order to monitor the pressure that occurs when the brain swells. This is only done in cases where a medical professional believes the swelling to be a concern. In some cases, the pressure is relieved by a drain placed into the skull.

These tests are commonly used to allow health care providers to take images of a patient’s brain. The various images along with a physical examination will allow a medical professional to form a diagnosis and immediately start the appropriate treatment.

Traumatic Brain Injury Treatment

The ultimate goals for the treatment of traumatic brain injuries are to resuscitate and support the patient, minimize secondary injury, and assist in their transition to recovery, as explained by the Mayfield Clinic. In the case of a mild TBI, the best treatment is usually rest and pain medication to relieve headaches. However, moderate to severe TBIs generally require more attention.

If an injury is life-threatening, a patient may be placed in a neurocritical care unit where they can be monitored around the clock. A neurointensivist will regularly monitor the patient’s brain function and mental status. Only patients with severe TBIs who are comatose or paralyzed, or in similarly severe condition, are taken into neurocritical care.

Medical professionals will commonly treat moderate to severe TBI patients with medication to control the following:

• Sedation & Pain
• Intracranial Pressure
• Seizures
• Infection

If necessary, moderate to severe TBI patients may require surgery to repair skull fractures, bleeding vessels, remove hematomas, relieve intracranial pressure, etc. The following surgical methods are commonly used:

• Craniotomy:
  The surgical removal of an area of the skull to expose the brain and allow a surgeon to repair damage. The area of the skull, called a bone flap, is removed then replaced after the damage is repaired.
• Decompressive Craniectomy:
  The removal of a section of bone to allow the brain to swell and expand. This surgery is performed on patients experiencing dangerously high intracranial pressure. Once the section of bone is removed, a biologic tissue is placed over the exposed brain, the skin is closed, and the bone flap is kept in a freezer. After 1 to 3 months of allowing the patient to stabilize, the bone flap is replaced in a surgery called cranioplasty.

Surgical procedures that aid in patient recovery include:

• Tracheotomy:
  Procedure in which a small incision is made in the neck into the trachea to allow access for a breathing tube. This is done on patients who are unable to breathe on their own which is common in cases of severe TBI.
• Percutaneous Endoscopic Gastrotomy Tube (PEG):
  This is a feeding tube that is inserted directly into a patient’s stomach through the abdominal wall. This aids severe TBI patients whose injuries may leave them unable to eat.

Rehabilitation for TBI Patients

The effects of moderate to severe TBI injuries can last long after the initial injury. For many who have suffered a TBI, rehabilitation is a crucial part of their recovery. There are a number of different forms of rehab, all aimed at promoting recovery from the effects of traumatic brain injuries. This includes, but is not limited to:

• Physical therapy
• Occupational therapy
• Speech therapy
• Psychiatric care
• Social support

Every rehabilitation program is designed based on the needs of the patient. The patient may be regularly treated by several different types of healthcare providers. The program will most likely change over the course of treatment as the patient heals. The length of a rehabilitation program depends entirely on how the patient responds to treatment. Some are able to heal completely while others, unfortunately, may require lifelong care.

Legal Assistance in Brain Injury Car Accident Cases

The potential damages sustained in a brain injury from a car accident can be extreme. Those who have suffered a moderate to severe TBI may be subject to high medical bills from various diagnostic tests, medicinal treatments, surgical treatments, and/or rehabilitation. The effects of serious TBIs can leave a patient with lifelong effects that prevent them from returning to work.

Those who have incurred a traumatic brain injury as the result of another party’s negligence in a car accident have a legal right to receive compensation for damages including medical bills, time away from work, and pain and suffering. A personal injury lawyer with experience in cases involving brain injuries from car accidents can review the facts of a case and guide a victim to obtaining the compensation they deserve.

If you or a loved one has suffered a brain injury as a result of a car accident, it’s important to understand your legal rights. The New York car accident lawyers at Block O’Toole & Murphy can help you seek compensation for damages. We attained the largest non-medical malpractice verdict in Long Island history, $32.7 million, for a former railroad conductor who was struck by a car and suffered severe brain damage.

Additional auto accident results where the victim suffered brain damage include:

• $13,500,000 settlement for a pedestrian that suffered a traumatic brain injury to the left frontal lobe after she was struck by a car while walking home at night.
• $8,800,000 recovery for a woman who sustained a traumatic brain injury that required immediate surgery. As a result of the auto accident, she still suffers from some cognitive and neurological issues.
• $7,525,000 settlement for two surviving children in a fatal car crash that killed their mother and brother. One of the survivors sustained a brain injury.
• $2,558,000 settlement in a tragic Brooklyn case for family of a car passenger who suffered a traumatic brain injury and died nine months later.
• $2,450,000 award for a motorcyclist struck by another vehicle. As a result of the crash, he developed a permanent cognitive disorder and retrograde amnesia.
• $2,250,000 recovery for an upstate New York driver who suffered a brain hemorrhage as a result of a head-on collision.
• $2,025,000 settlement for a Queens car crash victim who developed a casually-related seizure disorder and was unable to work as a result of the seizures.
• $1,500,000 settlement in a Bronx case for victim who suffered a brain injury caused by brain hemorrhaging and skull fractures. As a result of her injuries, she developed a neurocognitive disorder which affected her memory.

If you or a loved one suffered brain damage as a result of a car accident, the attorneys at Block O’Toole & Murphy understand how devastating the injury can be to you and your family. Learn your legal options by speaking with a qualified brain injury attorney today. Simply call 212-736-5300 or fill out our online contact form.