Helping Understand Traumatic Brain Injury Traumatic brain injury is an acquired, not naturally occurring, type of brain injury

which occurs when damage to the brain is caused by a sudden trauma to the head. TBI can occur as the result of a foreign object such as a bullet piercing the skull and entering brain tissue as was the case in the recent shooting of Gabrielle Giffords by Jared Loughner, or TBI may occur when the head violently is hit by or hits an object. Approximately half of all severely head-injured patients will require surgery to repair or to remove hematomasruptured blood vessels or contusions bruised brain tissue. Depending on the severity of the injuries to the brain, disabilities may occur as the result of traumatic brain injury. Approximately 1.7 million Americans suffer a traumatic brain injury each year. Sadly nearly one-third of these victims are children. Over 50,000 Americans die every year as the result of traumatic brain injuries. Moderate traumatic brain injury is a brain injury resulting in loss of consciousness for between 20 minutes and six hours, considered a Glasgow Coma Scale of nine to twelve. Severe traumatic brain injury can be defined as a brain injury which has as its end result a loss of consciousness for a time period longer than six hours, considered a Glasgow Coma Scale of three to eight. Common Disabilities Associated with Traumatic Brain Injuries Include the Following:

Cognitive problems including reasoning, memory, and thought Sensory processing problems with all five or some of the five senses of hearing, sight, touch, taste and smell Communication difficultiesproblems with comprehension/understanding and with selfexpression Changes in personality Depression Anxiety Aggressive behavioral changes Acting out in socially inappropriate situations Remaining in a largely unresponsive state or stupor and being able to be aroused only briefly and by a strong stimulus such as sharp pain Remaining in a coma and being totally unresponsive, unconscious, unaware, unable to be aroused. A vegetative statethe brain trauma victim is unconscious and not aware of his or her surroundings, but continues to maintain a sleeping-waking cycle and experience periods of alertness. Persistent vegetative state (PVS)the brain trauma victim remains in a vegetative state for longer than one month.

Moderately to severely injured victims of traumatic brain injuries such as Gabrielle Giffords are in need of rehabilitation involving individually tailored programs in the areas of speech and

language therapy, physical medicine, psychology/psychiatry, physical therapy, occupational therapy as well as social support during recovery. Mild TBI Traumatic brain injuries are classified as mild TBIs when loss of consciousness and/or confusion is less than 30 minutes in duration. Results of CAT and MRI scans may be normal, but the victim still experiences cognitive problems such as difficulty thinking and attention and memory problems. The victim will often have headaches and will also experience frustration and mood swings. Mild TBI often goes overlooked and undiagnosed. Other names for mild TBIs include the following:

Minor head injury Concussion Minor head trauma Minor TBI Minor brain injury

Symptoms Associated with Mild TBIs

Headaches Visual disturbances such as partial loss of vision, blurred vision, involuntary movements of the eyes, intolerance of light (photophobia), and difficulty in judging distances Fatigue Loss of memory Inability to focus attention or to concentrate/becoming easily distracted Impulsiveness Speech problems including not being able to understand the spoken word (receptive aphasia), difficulty being understood, difficulty reading and writing, etc. Disturbances in sleep patterns Loss of balance/vertigo Feelings of depression/anxiety Irritability Loss of the sense of smell (anosmia) Hearing problems such as ringing in the ears (tinnitus), decrease in hearing ability, and increased sensitivity Becoming overly sensitive to light Mood swings Nausea Thoughts slowed Becoming lost or confused Seizuresconvulsions usually associated with epilepsy which can be of several types and involve disruption in sensory perception, motor movements and level of consciousness

These symptoms may be delayed days or weeks in appearing. They may be so subtle as to be missed by family and health care providers. On the outside the victim appears normal. It is inside where the feeling and thought processes are not as they once were. Family and friends, however, may notice a change in personality or behavior before the victim himself or herself does. Victims of mild traumatic brain injuries benefit from rehabilitation. The Glasgow Coma Scale The Glasgow Coma Scale is one system by which medical professionals determine diagnoses for traumatic brain injuries. It is based upon a 15-point scale used to estimate and classify the effects of traumatic brain injuries. The test measures verbal, eye-opening, and motor response, assigning the following values: Verbal Response 1. 2. 3. 4. 5. 6. No sounds produced Incomprehensible sounds Jumbled phrases consisting of inappropriate words Confused but still coherent speech Localizes to noxious stimuli Obeys commands fully

Eye Opening 1. 2. 3. 4. No opening of the eyes Eyes open in response to pain Eyes open in response to speech Eyes open spontaneously

Motor Response 1. 2. 3. 4. 5. 6. No response Extensor response Abnormal flexion Withdraws from noxious stimuli Localizes to noxious stimuli Fully obeys commands

The final number score is determined by adding the values of all three categories. The resulting number helps medical professionals categorize possible survival levels with a lower number total indicating a more severe traumatic brain injury with a less favorable prognosis. Effects of TBI are often profound ones. Victims may be left in long-term states of unresponsiveness. Long-term rehabilitation is needed in order for the victim of a TBI to regain independence. A dramatic impact will be felt on the victims life as well as on the lives of his or her family members.

Gabrielle Giffords rehabilitation continues. Her plans are to return to her job in the U.S. Congress and to return to her family as soon as possible. Not all victims of TBI are so quick to recover. Recovery is a long, long road for victims of TBI.

Contact an Attorney
If you or a loved one has suffered from a traumatic brain injury because of a car accident, medical malpractice, or another instance which occurred as the result of someone elses negligence, contact a California personal injury lawyer at the Los Angeles firm of Banafsheh, Danesh & Javid, P.C. We serve greater Los Angeles County and surrounding areas. Call (800) 820-1111 or fill out our online contact form. Our personal injury lawyers have successfully represented thousands of clients throughout California. These articles are provided for informational purposes only and should not be considered legal advice. Professional legal counsel should be sought for specific advice relevant to your circumstances.