Mild Traumatic Brain Injury (MTBI)

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What Is MTBI?

Physicians and researchers are constantly developing a better understanding of mild traumatic brain injury (MTBI). Mild traumatic brain injury has been in the news regularly with the discussion of concussions in sports like football, soccer, hockey and rugby. The Centers for Disease Control and Prevention (CDC) defines a concussion as “a type of traumatic brain injury or TBI caused by a bump, blow or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a ‘ding,’ ‘getting your bell rung,’ or what seems to be a mild bump or blow to the head can be serious.” We have learned lately that repetitive “minor” trauma can cause serious future cognitive problems known as cognitive traumatic encephalopathy (CTE).

It’s Not Just Head Games

A good source of information on CTE is Christopher Nowinski’s “Head Games,” which focuses on the long-term problems of NFL players.

“Concussion” is a brain injury. All brain injuries are serious despite how they are categorized. Doctors apply a rating system called the Glasgow Coma Scale (GCS) to categorize concussions or TBIs into three areas of severity: mild (GCS 13-15), moderate (GCS 9-12) and severe (GCS <9). Despite the initial rating of the concussion or TBI, the true test of the severity of injury is how long its effects alter a person’s ability to operate in the real world.

Even for brain injuries rated as “minor,” victims can experience disabilities that include cognition problems (memory, thinking and reasoning), sensory processing problems (sight, hearing, taste, smell and touch), communication problems (ability to comprehend and speak), behavioral problems (depression, anxiety, aggression and personality changes) and physical problems like headaches. To treat such deficits, neuropsychologists and neuropsychiatrists are appropriate.

It is established that one can suffer an MTBI without losing consciousness, with normal CT and MRI studies, and with a normal neurological examination. Nevertheless, insurance companies, defense lawyers and their experts attempt to minimize the effects of an MTBI by emphasizing the lack of loss of consciousness, normal radiological studies and exams despite the medical literature. The CDC has made it clear that “MTBI symptoms may appear mild, but they can lead to significant, lifelong impairment in an individual’s ability to function physically, cognitively and psychologically.”

Each case of MTBI is unique so it is difficult to draw conclusions about its long-term effects. However, the CDC states that as many as 75 percent of all brain-injured people suffer MTBIs. Lifelong problems include persistent headache, confusion, pain, cognitive and/or memory problems, fatigue, changes in sleep patterns, mood changes and/or sensory problems as outlined above. The CDC correctly points out that most people diagnosed with MTBI recover fully and, depending on the seriousness of the blow, can recover within weeks or six to 12 months. However, there is a group of victims who make up about 15 percent of those diagnosed with MTBI who experience “persistent disabling problems.” This group is referred to as the “miserable minority.”

Of course, one can have a skull fracture or a bleed on the brain (e.g., subdural hematoma or epidural hematoma) and get a diagnosis of MTBI. However, complicating factors such as this often lead to a more serious prognosis.

What Should You Do If You Have Been Diagnosed With An MTBI?

If this diagnosis is related to an activity, an incident which you believe might involve the fault of another person, entity or a faulty product (e.g., a helmet), call us immediately: . Early contact allows preservation of evidence and ensures appropriate medical treatment like obtaining the best radiological scans to preserve evidence of your injury and getting the appropriate therapy and neuropsychological consultation that you need to get better.

With respect to school-aged children, accommodations (limitations on homework, increased time to take tests and grade modification) may be necessary to enable your child to stay in school. The first thing you must request is consideration of a “504 Plan.” This is a written plan pursuant to the federal Rehabilitation Act, Section 504, which offers all children with disabilities equal access to education. The 504 committee in your school can create a plan for your child that includes all accommodations.

The second tier of help in school is seeing if your child qualifies for an Individualized Education Plan (IEP). An IEP is a customized educational plan for a student who qualifies for special education. The Individuals with Disabilities Education Act (IDEA) was made the law of the land in 2000. It requires schools to provide IEPs for qualifying students. IDEA has 13 categories of qualifying disabilities, and “traumatic brain injury” is one of them. Once your child qualifies for special education, you will move beyond the 504 Plan.

You may find that your school is not as knowledgeable about your child’s rights as it should be. Consultation with will ensure that your child gets everything he/she is entitled to while dealing with the effects of a traumatic brain injury. We retain consultants who are experts in this field to assist you in maximizing your child’s benefits.

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For more information about mild traumatic brain injuries or to schedule a free initial consultation with an experienced personal injury lawyer, contact .

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