California Personal Injury Attorneys
What is "Mild" Traumatic Brain Injury?
Historically, words such as "mild",
"moderate", and "severe" were utilized to define brain
injury. For many years, these terms were utilized based on duration of
loss of consciousness.
Today, it is universally accepted that brain injury
can occur without loss of consciousness, without
direct external trauma to the head, and without positive findings on CT,
MRI, or other sophisticated diagnostic testing.
Acknowledging this latter point, in the 1995 Journal
of Neurotrauma it is stated:
"Although current computerized tomography
(CT) and magnetic resonance imaging (MRI) techniques have shown great
utility in diagnosing various aspects of traumatic brain injury, damage
resulting from mild diffuse brain injury often goes undetected with
these procedures." (Emphasis added). [Smith, D.H.; Meaney, D.F.;
Lenkinski, R.E.; Alsop, D.C.; Grossman, R.; Kimura, H.; McIntosh, T.K.;
Gennarelli, T.A.; (1995) New Magnetic Resonance Imaging Techniques for
the Evaluation of Traumatic Brain Injury. J.Neurotrauma 12(4): 573-577]
We at the Scarlett Law Group find it repugnant
to utilize terms such as "mild" or "moderate" to describe
a permanent brain injury. However, until the lexicon of health care practitioners,
experts, and others change, we seem destined to face use of these terms
to describe brain injury. We must, therefore, assist all those seeking
assistance, and even those who are not, with the true meaning of the words
"mild" and "moderate" as they pertain to brain injury.
When it describes a brain injury, we believe the word "mild"
is synonymous with "serious".
The Mild Traumatic Brain Injury Committee of the
Head Injury Interdisciplinary Special Interest Group of the American Congress
of Rehabilitative Medicine define mild traumatic brain injury as follows:
“A patient with mild traumatic brain injury is
a person who has had a traumatically induced physiological disruption
of brain function, as manifest by at least one of the following:
- Any period of loss of consciousness;
- Any loss of memory for events immediately
before or after the accident;
- Any alteration in mental state at the time
of the accident (i.e., feeling dazed, disoriented, or confused); and
- Focal neurological deficits that may or may
not be transient; but where the severity of the injury does not exceed
* Post-traumatic amnesia (PTA) not greater
than 24 hours;
* After thirty minutes, an initial Glasgow
Coma Scale (GCS) of 13-15;
* Loss of consciousness of approximately thirty
minutes or less;
This definition includes:
- The head being struck;
2. The head striking an object;
3. The brain undergoing an acceleration/ deceleration
movement (i.e., whiplash) without direct external trauma to the head.
It excludes stroke, anoxia, tumor, encephalitis, etc. Computed tomography
magnetic resonance imaging, electroencephalogram or routine neurological
evaluations may be normal. Due to the lack of medical emergency, or
the realities of certain medical systems, some patients may not have
the above factors medically documented in the acute stage. In such cases,
it is appropriate to consider symptomology that, when linked to a traumatic
head injury, can suggest the existence of a mild traumatic brain injury.
The above criteria define the event of mild traumatic
brain injury. Symptoms of brain injury may or may not persist, for varying
lengths of time, after such a neurological event. It should be recognized
that patients with mild traumatic brain injury can exhibit persistent
emotional, cognitive, behavioral and physical symptoms, alone or in combination,
which may produce a functional disability. These symptoms generally fall
into one of the following categories, and are additional evidence that
a mild traumatic brain injury has occurred.
Physical symptoms of brain injury (e.g., nausea,
vomiting, dizziness, headache, blurred vision, sleep disturbance, quickness
to fatigue, lethargy, or other sensory loss) that cannot be accounted
for by peripheral injury or other causes;
Cognitive deficits (e.g., involving attention,
concentration, perception, memory, speech/language or executive functions)
that cannot be completely accounted for by emotional state or other
Behavioral changes and/or alterations and degree
of emotional responsivity (e.g., irritability, quickness to anger, disinhibition,
or emotional lability) that cannot be accounted for by a psychological
reaction to physical or emotional stress or other causes.
Some patients may not become aware of, or admit,
the extent of their symptoms until they attempt to return to normal functioning.
In such cases, the evidence for mild traumatic brain injury must be reconstructed.
Mild traumatic brain injury may also be overlooked in the face of more
dramatic physical injury (e.g., orthopedic or spinal cord injury). The
constellation of symptoms has previously been referred to as minor head
injury, post-concussion syndrome, traumatic head syndrome, traumatic dephalgia,
postbrain injury syndrome and post-traumatic syndrome." J Head Trauma
If you or someone you know has been injured
or suffered Traumatic Brain Injury or TBI,
you need the assistance of The Scarlett Law Group.
today to speak with a California Personal Injury Attorney.