X-rays are one of the most common diagnostic imaging techniques used by
medical providers to determine injury. Injuries sustained by our clients
such as broken bones, disc protrusions and fractures and even foreign
objects left in the body can be clearly shown to a jury through the use
of X-ray evidence at trial. The Scarlett Law Group routinely presents
this powerful demonstrative evidence to paint a vivid picture for the
jury of the injuries our clients have suffered.
While X-rays are clearly helpful for the jury to visualize our clients’
injuries, they do have limitations. The Scarlett Law Group often utilizes
Computed Tomography Scans (CT Scans) to demonstrate hematomas (collections
of blood), contusions (bruising) and edema (swelling) in the head/brain
or other areas of the body. CT scans are performed by beaming a series
of collimated x-ray beams through the tested body and taking measurements
of the extent of tissue absorption.
Magnetic Resonance Imaging (MRI) examines body tissue by subjecting the
atomic nuclei of the tissues to a magnetic field. The atomic nuclei of
the tissues are then stimulated by the field. The response of the tissue
allows radiologists to determine areas of damage.
It is important to note that not all brain injuries can be shown by MRI.
Where there is no hematoma (subdural or otherwise), or no visible lesions,
MRI is limited. However, new advances in this important technology have
allowed for more accurate depiction of damage done during trauma.
In 2005, The Scarlett Law Group was one of the first law firms to utilize
this technological advancement in the courtroom. Mr. Rasmussen was involved
in a seemingly minor, low impact rear end accident. While less than $500
damage was done to his vehicle, our client suffered from severe cognitive
deficits due to the rotational acceleration/deceleration forces acting
upon his body. Immediately after the accident, a standard Tesla-1 strength
MRI was administered. This MRI did not show any lesions on the brain.
Shortly thereafter, Mr. Rasmussen contacted the Scarlett Law Group for
help. Mr. Scarlett agreed to represent him, and recognizing the groundbreaking
potential of the newly approved Tesla-3 MRI, sent Mr. Rasmussen to an
imaging center in Las Vegas for such an MRI.
Upon viewing the results, two focal lesions in the anterior and posterior
frontal lobes were clearly shown on the T-3 MRI and a conclusive diagnosis
of traumatic brain injury was made. In fact, as you can see in the first
two images below, when both the T-1 and T-3 MRIs are viewed side by side,
one can vaguely make out the lesions on the T-1 that were previously unidentifiable.
A powerful tool for demonstrating brain function is Positron Emission Tomography
(PET). While MRI and CT show brain structure, PET shows brain function.
In cases where an individual has negative CT or MRI, PET can be useful
in establishing interruption in normal brain function. PET scans utilize
short-lived radioactive isotopes of elements commonly used in brain metabolism.
In cases where an individual does not have a hematoma or skull fracture,
the use of PET scan technology can demonstrate to a jury that abnormalities
exist that are consistent with post concussive syndrome and “mild”
TBI. The Scarlett Law Group often uses PET Scans in correlation with neuropsychological
testing to convey to the jury the existence and effects of the “invisible
injury” our client has suffered.
Click the link below to view a PowerPoint presentation which has been kindly
provided by Dr. Joseph Wu and the University of California at Irvine Brain
Single Photon Emission Tomography (SPECT) scans are another commonly used
piece of demonstrative evidence. SPECT Scans study circulation and perfusion
of the brain, producing regional maps of the distribution of radioactively-labeled
tracers in the brain. These maps are of much higher quality and resolution
than more commonly applied brain scans, but avoid the high cost and unavailability
of PET scans.
The Scarlett Law Group uses SPECT scans to demonstrate brain injury to
a jury by showing focal vascular defects due to the brain shutting off
its own blood supply to an area of damaged brain tissue. Often times,
SPECT scans are also used to help validate neuropsychological assessments.
DTI-Diffusion Tensor Imaging
Diffusion Tensor Imaging (DTI) is another emerging type of MRI that the
Scarlett Law Group is utilizing as cutting edge demonstrative evidence.
DTI is able to view portions of the brain which normal MRIs cannot. DTI
measures water molecule movement in relation to white track fibers of
the brain’s white matter. In a normal DTI scan, water molecules
move parallel to the white matter tracks. Where traumatic brain injury
has occurred, water molecules will move perpendicular to the normal tracks
of white matter. The Scarlett Law Group utilizes DTI most often in cases
involving Diffuse Axonal Injury where brain damage is not present in just
one focal area, but across large portions of the brain. Diffuse Axonal
Injury is present in almost half of severe
traumatic brain injuries, and commonly in mild and moderate traumatic brain injuries, so the use
of DTI has become a crucial, cutting edge piece of demonstrative evidence
used at trial by the Scarlett Law Group to explain complex brain injuries
to a jury.