It's usually obvious where someone is injured in a car accident. Bruises, abrasions and lacerations are visible injuries that show up quickly after impact. Victims may also experience pain from soft tissue injuries to their neck and back. Usually, the pain from these types of injuries is felt immediately after the collision or soon thereafter, and so you are able to pinpoint the cause of your injuries and seek the necessary treatment. The most common type of injury that may not be visible, however, is that of what is referred to as a “minor traumatic brain injury,” or MTBI.
Myth: you must lose consciousness and strike your head in order to have a brain injury
Generally, when one thinks of a brain injury, they think of injury to the brain as a result of a blow to the head that results in a loss of consciousness. While a head injury can certainly occur after such an event, studies have shown that one can sustain a closed head injury without losing consciousness or suffering from an actual impact to the head. In a closed head injury, trauma to the brain can occur after a flexion/extension or acceleration/deceleration type injury. Your brain is essentially the consistency of gelatin that is confined within your skull. Your skull is actually very rigid and lined with bony protrusions on the inside. An acceleration/deceleration type injury, wherein your head snaps forward and then backward very quickly in time, can cause the gelatin of your brain to move forward and bounce off the bony protrusions lining your skull and then bounce backward hitting the opposite side of your skull. This type of injury is referred to as “coup contre coup.” While there may not be any outside forces of trauma, the bouncing of your brain against your skull can be enough to result in damage.
Myth: If an MRI or CT scan fails to reveal any abnormality, then there is no brain injury
Another fallacy often used by insurance companies when defending against a claim that someone has suffered a minor traumatic brain injury is that if someone sustains a brain injury, it will undoubtedly appear on diagnostic testing. Because we are in the year 2014 and our imaging technology has advanced dramatically in the past 20 years, this fallacy may be understandable. However, this incorrect way of thinking can be detrimental if not countered immediately. In reality, a patient can have normal testing and still be suffering from cognitive impairment. This is because while powerful and advanced, these tests can fail to detect the microscopic damage done to the axons and neurons of your brain.
Myth: A patient undergoing a Neuropsychological Evaluation can impact the results because the testing is subjective
A neuropsychological evaluation can be used to assess whether an individual has a brain injury. This type of evaluation utilizes a battery of tests to analyze a patient’s cognitive, motor, and perceptual skills in a way that is sensitive enough to detect a disruption in the normal function of your brain. In general, a neuropsychological evaluation will include tests that measure one’s attention and concentration; learning and memory; reasoning and problem-solving; visual-spatial functions; language and speaking ability; sensory-perceptual and motor functions; academic skills as well as emotional functioning. This type of evaluation is conducted in a question and answer type format, as opposed to being subject to a machine or other physical invasive means.
Because of the subjective nature of the exam and the need for patients to put forth their “best efforts” in order to obtain adequate test results, insurance companies often argue that the test is, therefore “subjective” and should not be considered as an “objective” medical finding. However, medical literature has sufficiently disputed this in the past. It is now well accepted in the medical community that a neuropsychological evaluation includes comprehensive objective assessments and can aid in the detection of subtle changes in brain function that are not detected in diagnostic studies.
Myth: You will quickly recover from a MTBI
Defense attorneys and insurance companies will often try to diminish the extent of the injuries of those who have suffered a minor traumatic brain injury by arguing that any effects will not be long-standing in nature and should resolve quickly. While issues with memory, concentration, headache, and fatigue may resolve within a year following the injury, some individuals still have persistent problems and require further treatment. Moreover, some symptoms of a MTBI may not immediately present themselves and are subtle in nature like a slight loss of smell, mood changes, or sensitivity to light and sound. Some symptoms and effects will last longer than others and every individual is different—what remains the same though is the way that defense attorneys will often try to attack your injuries and the true extent of your damages.