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Understanding Traumatic Brain Injury After a Car Wreck or other Accident

DSCN1837.JPGWhen a person is injured in a car wreck, motorcycle wreck, or other personal injury, sometimes the most harmful injuries are those that you cannot see with the naked eye: a brain injury. Sometimes brain injuries are obvious and an injured person's functioning is so impaired that they are left unable to speak, walk, or feed themselves. Other times, the brain injury is subtler. Called a mild traumatic brain injury (mTBI) , these injuries can be as devastating as a spinal cord injury or any other serious injury. However, because the injured person may "look" normal, it can be more difficult to recover compensation for these types of cases.

Brain Anatomy

The human brain is the most complex and sensitive organ in the body. Weighing only about 3 lbs., the brain is the essence of what makes a person who they are. There are several parts to the brain, and each part has its own function. The three (3) main parts are the cerebrum, cerebellum and the brain stem. The brain stem is located at the base of the brain and contains the midbrain, pons and medulla. This section of the brain is responsible for automatic body functions such as breathing, heart rate, digestion, and regulating body temperature. It also serves as a relay system between the rest of the brain and the central nervous system. An injury to this area of the brain usually is catastrophic and results in death.

The cerebellum is above the brain stem and it coordinates muscle movements and balance.

The largest part of the brain is the cerebrum and is divided into right and left hemispheres. This part of the brain is associated with higher brain function including thinking, memory, and emotion. It is filled with approximately 100 billion neurons which are elongated nerve cells that transmit signals to each other through electrical and chemical signals. The communication between these cells enable us to think, have emotion, react to stimuli, and remember. These cells are very small, about 30,000 neurons can fit on the head of a pin, and can only be observed under strong microscopes.

The brain has the consistency of firm jelly. It floats in fluid, called cerebra spinal fluid, which acts as a shock absorber. It is also surrounded by protective tissue called meninges. Outside of the meninges, the brain is surrounded by the skull.

Injury to the Brain

Despite its protective coating, the brain can suffer injury when the head suffers a blow or the head is thrown forward and backward quickly, as can happen in a car wreck. The brain is subject to the same laws of physics as everything else, and when a person is in a car wreck at 45 mph and comes to a sudden and violent stop, the brain continues its motion until it, too stops, by striking the inside of the skull.

When the brain impacts the skull, a mild traumatic brain injury can occur. Some of those billions of neurons can be damaged, the axons of the nerve cell can be bent or broken, and the ability of the brain cells to "talk to" each other can become impaired. When this type of injury happens, the person may have difficulty talking, remembering information, or controlling emotions.

Symptoms

Each brain injury is unique. Like a fingerprint, as each person has a unique brain, each person's symptoms of and reaction to a brain injury is different. However, some common symptoms include:

- Loss of consciousness

- Seeing stars

- Confusion

- Loss of appetite

- Irritability

- Nausea

- Sensitivity to Light/ Noise

- Blurred vision

- Headache

- Fatigue

- Loss of sense of smell

Symptoms that might manifest themselves at a later date include:

- Difficulty following conversations

- Struggling to find the right word

- Mood swings

- Difficulty with short term memory

- Sleep disturbance

- Lashing out and yelling at family members

- Withdrawal and disengaging from social situations and friends and family

Why can't we see a mTBI on an x-ray, CT scan or MRI?

X-rays, CT scans, or MRIs are very good tools at getting a picture of the human body. Think of these tools as good digital cameras taking pictures of inside of the body. They can spot diseases, broken bones, and internal organ damage. They help doctors see inside a patient's body without having to cut open the body and look for themselves.

What these tools cannot do, however, is see the body's cells up close. Instead of the digital camera, due to the very small size of neurons, a doctor needs a microscope, and a very powerful microscope at that. Because we cannot take brain cells out of the brain and look at them under a microscope, mild traumatic brain injury cannot currently be diagnosed with scans or blood testing on a living patient. Researchers are working on ways to find brain injury by blood testing, by tracing protein levels (Tau proteins), but this research is still in development and not available to the public.

Recovery

The outcome of a person who suffers a mild traumatic brain injury can be difficult to predict. As each brain injury is different and unique, a person's ability to recover is unique. However, certain factors can make a good recovery more likely. Younger individuals, for example, are more likely to recover from brain injury than older individuals. Obtaining therapies from a qualified speech therapist can also help. An injured patient is also more likely to recover if they obtain competent medical care following their accident. Many people make a full recovery. However, some injured people do not. Doctors predict that most of an injured person's recovery from a mild traumatic brain injury will occur within the first year after the accident. After that point, recovery is not as certain. Additionally, persons suffering from mTBI are at higher risk for developing dementia and Alzheimer's disease later in life.

Summary

Many people who suffer from mild traumatic brain injury look normal at first glance. However, although the injury may be invisible to the casual observer, it is very real. Injured persons need our support and encouragement. With time and luck, they may return to a functioning level. For those that do not, the injured person needs the best care medicine can provide and our compassion.

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