Biomechanics of TBI
Biomechanics of Traumatic Brain Injury (TBI)
A picture is worth a thousand words. Despite this, some trial lawyers think it is a mortal sin to try a case in an interesting manner. They seem to think it is beneath their dignity to make a case a living, pulsating experience; a vivid portrayal of the tragedy that occurred. Try a case in a humdrum manner and the result will be a humdrum verdict.
Your lawyer must capture and hold the imagination and the interests of the jury, as well as garner their respect. Your lawyer must make the jurors live your case; make them participate in the joint endeavor of righting a wrong; make them feel that theirs is the voice of the community.
Sadly, more often than not, this is not done. If anything, technology has hindered society´s ability to “see” through words. Many jurors, used to watching a drama unfold on television, are ill-equipped to follow a trial devoid of demonstration. If anything, the words of the lawyer may do nothing more than lull the juror to sleep. This is particularly so where complex events occur. In many instances, the only way we can possibly understand the true sequence of an event is to see it, as well as hear about it.
This having been said, it is also true that a trial is about moderation. Simply because we can present certain evidence through a multimedia event does not mean that we necessarily should. But where the complexity necessitates the need and the capability is present, then not to use the technology will guarantee a bad outcome.
“Condensed to its most simplistic, there are three major mechanisms which contribute to traumatic brain injury. These include: (a) impact of the brain against the skull; (b) shear between layers of the brain; and (c) cavitation.”
Bringing Cases to Life at Trial
It was only 50 years ago that lawyers struggled to use a blackboard at trial. Today, plasma monitors and videotapes of real-time teleconferencing are commonplace. Computer reenactment, animation, and utilization of high-tech substances, such as brain gel, can be used with proper foundation. Dramatic impeachment through replay of videotaped depositions is now an essential part of any trial.
Blackboards, easels, charts, graphs, aerial photography, photographic blow-ups, powerpoint presentations, models, computer reenactments, plasma monitors, visual presenters, trial demonstration software, even holograms are used in today’s trials. A proper demonstration of how an accident or injury occurred may be the difference between a verdict for the plaintiff or defendant.
Mechanics of Brain Injury
Traumatic brain injury or a closed head injury can occur when the head is subjected to a direct external impact (such as where the head is struck, or where the head strikes an object).
Likewise, injury can occur when the head is subjected to a sudden acceleration and then is suddenly stopped. A sudden acceleration/deceleration (oftentimes causing diffuse axonal shearing and other times causing coup/contra coup injuries) often follows a violent flexion-extension movement of the head. This response is extremely common in rear-end vehicle collisions.
Condensed to its most simplistic, there are three major mechanisms which contribute to traumatic brain injury. These include:
- impact of the brain against the skull;
- shear between layers of the brain; and
Depending upon how the impact occurred, be it a rear-end collision or another cause, the head starts its movement to the rear while the brain resists, leaving a space at the back of the skull. As this force progresses, a centrifugal force lifts the brain, thereby leaving spaces between it. Both inertia and centrifugal force causes the brain to impact against the skull. This impact may cause damage to the brain.
While the skull provides considerable external protection because of its strength, its inner-contours are not smooth and are characterized by sharp, bony proturbences. When a blow is dealt to the head, the brain is flung against these bony proturbences and is bruised and torn, resulting in brain damage.
Another mechanism of brain injury is that of shear. Shear is based on rotational acceleration/deceleration, and a sliding effect of one layer of the brain upon another. Shear occurs within the brain because of the difference of density in layers.
Axonal shearing can occur where an axon transverses between two or more layers of the brain which are subject to shearing forces. Oftentimes, damage to the axons is diffuse and degeneration happens throughout the brain rather than in specific clusters. Diffuse axonal shearing is a common cause of “miild” traumatic brain injury, and is rarely visible upon imaging.
Cavitation occurs when mass moves rapidly through fluid. The pressure in front of the mass is high and the pressure behind the mass is low. Vapor filled bubbles form in low pressure. When a mass returns in the opposite direction, the bubbles collapse. If this occurs often, the brain can be injured.
Many times, injuries are found opposite the point of impact. This type of injury is called the “countre-coup,” a French term meaning “against the blow.” Cavitation is the most commonly accepted explanation for this type of injury.
Work-up of the biomechanics of injury are especially required in the proper trial presentation of any traumatic brain injury case. The Scarlett Law Group works with the top experts in the world on this subject. Below, you will see the lengths to which the Scarlett Law Group routinely works with biomechanical experts in order to demonstrate the mechanics of injury.
Landmark Case Results
Plaintiff: Claude Herndon
Scarlett Law Group represented Claude Herndon as a result of traumatic brain injury which occurred when the stool upon which Mr. Herndon was sitting fell into a concealed hole in the casino floor, causing Mr. Herndon to be propelled forward where he hit his head upon the casino’s slot bank table. First, accurate photographs were taken of the actual location of the fall. Friction measurements were taken of the table top, together with appropriate documentation of the concealed hole and stool.
Plaintiff: Jamil Keegan
The Scarlett Law Group represented Mr. Jamil Keegan after he sustained a traumatic brain injury from a construction site accident. Mr. Keegan’s shirt was caught by a pipe that was being threaded in a pipe threading machine. The operator was oblivious to the problem experienced by Mr. Keegan as his shirt became entangled with the pipe, wrapping tighter and tighter, before Mr. Keegan was thrown over, striking his head on the concrete workplace floor. The Scarlett Law Group obtained an identical pipe threading machine, and in essence, reenacted the accident.
Rasmussen v. Shade
On July 7, 2005, in Rasmussen v. Shade, et al., SCV 14935, Placer County Superior Court, Lincoln Division, the jury reached its verdict awarding Kim Rasmussen $1,248,024.00 as a result of injuries he sustained in a relatively minor rear-end automobile accident in Roseville, California. On August 19, 2002, Plaintiff Kim Rasmussen was operating his 1997 Ford F-250 pickup truck on Eureka Road near Sunrise in Roseville, CA. Defendant Bruce Robert Shade caused his 1999 Dodge Durango to rear end plaintiffs’ pickup at about 7mph – 12mph. Plaintiffs truck sustained $498.00 damage to the rear bumper. Despite the relatively minor property damage, counsel was able to establish that the rotational forces were sufficient to cause Mr. Rasmussen to sustain a traumatic brain injury. Leading experts throughout the United States testified on behalf of Mr. Rasmussen, and the Jury’s Verdict should ensure that he receives the future medical care he so desperately needs.
Shi v. Coach
On April 7, 2005, plaintiff Celia Shi’s life was forever altered when a COACH USA Grey-Line Tours Bus made an illegal left-hand turn striking Ms. Shi in the crosswalk.
After being struck by the tour bus, Ms. Shi was thrown to the ground and sustained skull factures with internal bleed. Ms. Shi underwent four life-saving surgeries with the expert neurosurgical team at San Francisco General Hospital, led by renowned neurosurgeon Dr. Geoffrey T. Manley.
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. Call (415) 688-2176 today to speak with a California Personal Injury Attorney.