Brain Injury Diagnosis | St. Louis Brain Injury Attorneys | TBI Lawyers
How Does a Doctor Diagnose Traumatic Brain Injury?
When a doctor makes a diagnosis, he or she decides what illness or injury a patient has by making an examination, performing tests, and looking at the person's symptoms. Traumatic brain injury (TBI) is usually broken down into three classifications: severe, moderate, and mild. To diagnose TBI, doctors perform a neurological examination, for example checking whether pupils react normally to light, are fixed, or are of different sizes. In addition, a doctor will consider whether the patient lost consciousness and/or lost memory (amnesia). Generally the longer the period of unconsciousness and amnesia, the more severe the traumatic brain injury.
Sophisticated machines can make images of the brain that show damage to the brain tissue, bleeding, and bruising from moderate or severe brain injuries. The preferred imaging test in the emergency setting is a computed tomography (CT scan). Magnetic resonance imaging (MRI) shows more detail than a CT scan and is used to predict how well the patient will do over the long term. MRI is also used for detecting diffuse axonal injury. Angiography may be used to study blood vessels, and functional imaging can measure cerebral blood flow. Electroencephalography and transcranial doppler may also be used.
Diagnosing Moderate and Severe Traumatic Brain Injury
Physicians have little trouble diagnosing moderate to severe TBI because the physical damage to the brain is easily seen by eye or through imaging scans. There is no doubt a person has suffered a moderate to severe brain injury when he or she has a fractured skull, penetrating or perforating injury, bleeding inside the head, or swelling of the brain tissue. These injuries are life threatening, and can be seen on an MRI or CT scan.
Coma, Persistent Vegetative State, Death
Whether a patient is classified as having a moderate or severe traumatic brain injury also depends on how his or her body responded to the initial open or closed head injury. Severe head injury often results a long period of unconsciousness, coma, persistent vegetative state, or even death.
Coma: A person becomes comatose when he or she is unconscious for more than six (6) hours, will not wake up, will not respond normally to pain, light or sound, does not have a normal sleep-wake cycle, and does not move in response to directions. Those who survive coma after a severe head injury often have devastating permanent disability requiring extensive rehabilitation and sometimes long-term care.
Vegetative State: A severely brain damaged victim is in a vegetative state when he or she progresses from a coma to becoming partially awake, but without a true awareness of what is happening around him or her. After four weeks in a vegetative state, the victim is classified as in a persistent vegetative state.
Death: Those with the most severe brain damage do not survive.
Traumatic Brain Injury Grading Scales
To determine whether a traumatic brain injury is severe, moderate, or mild, doctors use two methods to "grade" open head injuries and closed head injuries:
Glasgow Coma Scale - The Glasgow Coma Scale is commonly used to assess the severity of traumatic brain injuries, including closed head injuries. The scale tests eye, verbal, and motor responses to see if the victim can see, speak, move, and respond to commands. The scale goes up to fifteen points with fifteen being the most mild injury, less than eight being a severe brain injury, and less than three being a vegetative state.
ASCOT - The ASCOT probability of survival incorporates several of the Glasgow Coma Scale tests, but also includes an evaluation of systolic blood pressure, respiration rates upon admission, and anatomic (physical) injuries. The ASCOT has been found to be the most sensitive tool for determining the severity of head injuries in children. Doctors use the ASCOT to predict whether the victim will recover.
Diagnosing Mild or Minor Traumatic Brain Injury
Diagnosing mild or minor brain injury is harder than diagnosing moderate to severe brain injury. Historically, doctors have under-diagnosed mild traumatic brain injury, and victims with legitimate mild TBI have gone untreated. This is unfortunate because even a "mild" injury may cause short or long term impairment, disability, and inability to function. A World Health Organization study estimated that between seventy (70) and ninety (90) percent of head injuries are mild. A United States study found that moderate and severe injuries each account for ten (10) percent of TBIs, with the rest mild.
Many doctors, including internists and neurologists, do not fully understand minor or mild brain injury, making it hard for them to diagnose it and treat it. A person with mild TBI may appear normal to an emergency room physician. Doctors often fail to diagnose TBI in people who did not lose consciousness. Studies have shown complete loss of consciousness for a long period of time is not a necessary symptom of TBI. TBI can occur when unconsciousness is brief, seconds to minutes, or when there is no loss of consciousness at all, but merely a short period of feeling dazed or confused. A mild closed head injury or a minor brain trauma may not show up on MRI or CT scan. However, within a short time after the injury, many mild brain injury victims begin to experience memory loss, difficulty thinking and processing information, and impaired ability to handle everyday jobs and responsibilities.
Tests for Mild Traumatic Brain Injury
Conventional CT scans and MRI exams do not show minor brain trauma, so there is no clear visual medical evidence of mild traumatic brain injury. Without objective medical evidence, it becomes more difficult to convince insurance adjusters and other professionals that there is in fact an injury. To the jury and an insurance adjuster, the victim of mild TBI may seem very healthy, particularly if he or she is able to walk, talk, and perform normal everyday activities. They may not see the subtle changes such as loss of memory, change in personality, or depression. A St. Louis brain injury lawyer can coordinate with a medical professional to perform other tests that can show the nature and extent of brain injury including:
- quantified EEG or a BEAM study 21
- a PET scan 22
- a SPECT scan
These examinations are highly sensitive tests to determine whether there has been neuron shearing in any part of the brain. Charts made after these examinations that clearly show any damaged areas can be given to a jury as evidence and a St. Louis brain injury lawyer will have the necessary medical experts and skill to provide these demonstrations in the courtroom.
Other Ways to Prove Mild Traumatic Brain Injury
After an accident, it is often a person close to the victim such as a spouse, child, friend, family member, or co-worker who notices subtle changes in the victim's personality or behavior, like mood swings and forgetfulness. These witnesses can play a major role in helping a St. Louis brain injury lawyer to learn the background of the victim, obtain a complete statement of the traumatic event, and get a clear picture of what has happened to the victim since the accident. In addition, the St. Louis brain injury lawyer will likely recommend the victim have:
- a complete evaluation by a physician
- a complete neuropsychological evaluation
- a complete speech and language therapy evaluation
- a complete physical therapy evaluation
- a complete occupational therapy evaluation
Proving the mild brain injury is real is the first step toward getting compensation for the TBI that has altered your life, or the life of a loved one. Proving a mild brain trauma case requires a St. Louis brain injury attorney to invest hard work, considerable effort, and substantial funds to get the victim the recovery he or she deserves. Contact a St. Louis brain injury lawyer today if you believe that you or a loved one have suffered a traumatic brain injury.
After Diagnosis, the Real Work for the Family Begins
There is no doubt that the families of brain injury victims become quickly overwhelmed with the sudden changes that turn their lives upside down the moment a loved one suffers a head injury and is diagnosed with traumatic brain damage. Families and caregivers work tirelessly to care for brain injury victims, often with little time off for themselves, and often without any outside assistance. Respite care, including day centers and leisure facilities for the disabled, offer time off for caregivers and activities for people with TBI.
St. Louis Day Care Centers and Leisure Facilities: Offering Caregivers a Needed Break
Young In Spirit Adult Day Center
6150 Oakland Avenue
Saint Louis, MO 63139
St Elizabeth Adult Day Care
3401 Arsenal Street
Saint Louis, MO 63118
Ronal C Bridewell Christian
2822 Doctor Martin Luther King Drive
Saint Louis, MO 63106
Agape Adult Day Health Care
915 North Taylor Avenue
Saint Louis, MO 63108
8941 Riverview Drive
Saint Louis, MO 63137
St Elizabeth Adult Care Center
9723 Grandview Drive
Saint Louis, MO 63132
Brain Injury Lawyers and Brain Trauma Attorneys Serve St. Louis and Surrounding Cities
Serving clients throughout Eastern Missouri, including Affton, Alton, Ballwin, Belleville, Cape Girardeau, Carbondale, Charleston, Chesterfield, Collinsville, Columbia, Dardenne, East St. Louis, Edwardsville, Ellisville, Eureka, Ferguson, Florissant, Granite City, Jefferson City, Kirkwood, Lake St. Louis, Maryland Heights, Mehlville, Murphy, Oakville, O'Fallon, Quincy, Spanish Lake, Springfield, St. Ann, St. John, St. Louis, St. Peters, Troy, University City, Waterloo, Webster Grove, Weldon Spring, Wildwood, areas in the vicinity of BNSF-St. Louis, Boeing, CSX-East St. Louis, Ford Motor Assembly Plant, Lambert-St. Louis International Airport, NS-St. Louis, Scott Air Force Base, Spirit of St. Louis Airport, UP-St. Louis, and other communities in Greater St. Louis.
If you have suffered a traumatic brain injury in the Greater St. Louis area, St. Louis County, or a surrounding area, you could be entitled to compensation, whether the cause was negligence or breach of a standard of care. Act now and hire a qualified St. Louis brain injury lawyer to represent you!