People with Persistent Symptoms After mTBI Need Additional Support During Litigation

Traumatic brain injury (TBI) is a common cause of morbidity and mortality worldwide. Though more than 70% of TBI cases are mild (mTBI) or concussion, these people may experience neurological deficits and other poor outcomes for months or years after injury. Additionally, people who are in the process of injury-related litigation may also suffer from greater anxiety and depression than other mTBI patients, suggesting that the stress of litigation may intensify their symptoms. For these people, early detection of brain injury patterns – which are associated with long-term TBI symptoms – is crucial.

Magnetic resonance imaging (MRI) techniques allow clinicians to detect injury-related brain lesions in people with mTBI. A recent study of such techniques investigated the effectiveness of two imaging approaches, susceptibility-weighted imaging (SWI) and fluid-attenuated inversion recovery (FLAIR), as methods of lesion detection. Personal injury attorneys referred 180 patients with persistent neurological symptoms after injury (83% of whom had mTBI), while 94 non-symptomatic participants volunteered to participate as a control group. After comparing each group’s SWI and FLAIR results, the researchers found that:

  • Both FLAIR and SWI detected a significantly greater amount of brain lesions in the symptomatic people with mTBI than in the control group.
  • For younger people (under 45 years old), FLAIR and SWI detected lesions at a lower rate.
  • FLAIR was more sensitive to TBI-specific lesions than deeper or age-related lesions.

For people already suffering from the chronic effects of mTBI, the injury litigation process can present additional stressors and symptoms that are associated with poor outcomes. MRI is a valuable tool for detection of the brain lesions that underlie these patients’ ongoing symptoms. Early recognition and treatment of these injuries can dramatically improve patients’ quality of life during the litigation process.

Trifan G, Gattu R, Haacke EM, et al. MR imaging findings in mild traumatic brain injury with persistent neurological impairment. Magnetic Resonance Imaging. (December 2016).

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