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. One of Mr. Scarlett's clients 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 in the brain.
Shortly thereafter, the client 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.
Today, many institutions maintain MRI's of T-7 or higher strength. The FDA only allows T-3 MRI in non-fatal cases.
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.
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. Oftentimes, SPECT scans are 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 damage to the fiber tracts of the brain. 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.