Trial Magazine

Mild traumatic brain injuries (mTBI) are a silent epidemic: As many as 60 percent of cases go undiagnosed. Clinical research shows that the consequences can be anything but mild. Characterized by little or no loss of consciousness and/or confusion or disorientation lasting less than 30 minutes, mTBI symptoms include memory loss, headaches, personality changes, and emotional disturbances. Here are some ways to recognize mTBI in your clients.

As many as 60 percent of mTBI cases go undiagnosed.

Little evidence of physical injury. Someone suffering from an mTBI may have only minor physical injuries—perhaps bruising or a small cut. Compare and contrast your client’s physical injury to the damage to the vehicle or other structure. Impact forces to the vehicle lead to impact forces to your client, and severe crush damage to the vehicle will confirm severe impact forces to your client, even in the absence of external physical injury. Negative diagnostic tests also do not rule out mTBI, which are typically associated with normal structural neuroimaging. The physical brain structure may be intact, but its ability to process is compromised.

Anger, isolation, and personality changes. Although the physical injuries may be minor, personality changes—including aggression, anger, confusion, frustration, and unpredictable behavior—are a telltale indication of an mTBI. Think of the brain as the computer or operating system that controls the body. What happens to a laptop when you drop it, or when there is a power surge? It might look fine on the outside but have substantial invisible damage.

Loss of consciousness. A common misperception is that all TBI require a loss of consciousness. While this is a key indicator, it may not be present in all mTBI cases. Moreover, the client may not remember losing consciousness, so question emergency personnel and other fact witnesses to confirm or deny this. If there is no evidence of loss of consciousness, other symptoms can still demonstrate mTBI, such as disorientation, headaches, vision changes, personality changes, or memory loss. Testimony from primary care physicians and close friends and family can be critical in establishing these symptoms.

When your client appears to have symptoms of an mTBI, it’s crucial to evaluate these factors.

Brett A. Emison is a partner at Langdon & Emison in Lexington, Mo. He can be reached at brett@lelaw.com.