Understanding Traumatic Brain Injury (TBI) in Wyoming
A traumatic brain injury is the most frightful and potentially devastating type of non-fatal injury you can receive. In recent years, the per capita rate of fatal TBI injuries in Wyoming has been twice that of the national average. For the two out of three who survive the initial injury, the road to recovery is no easy path as they are faced with the daunting prospect of long-term after effects. The Wyoming Department of Health determined that the combined average of loss of work and medical costs alone amounted to $1.2 million per TBI in 2016. Car accidents are responsible for a third of all TBI cases in Wyoming and one of the leading causes of this type of injury.
These statistics offer a sobering glance at TBI’s impact. However, these statistics do not begin to address the painful reality of living with this injury. This pain is not only for the victim, but the victim’s family, friends, and community as well. To understand the dreadful nature of this type of injury we need to first examine the medical side.
What is a Traumatic Brain Injury?
The term TBI covers a wide range of injuries to the brain. Almost any injury to the brain you were not born with and is not part of a degenerative disease is considered a TBI. The injury is typically caused by a blow or other sudden force applied to the head or body. The injury can be the result of something penetrating the skull, or the damage can be completely contained inside the cranial cavity.
A traumatic brain injury can range in severity from very mild to gravely serious. A very slight TBI would be a minor concussion, while a more acute injury could result in paralysis or significant cognitive impairment. Any TBI, by its very nature, is a very serious injury that can have a lasting impact on the life of the victim.
Brain Location Matters
The unique physiology of the brain makes the precise location of the injury a major factor in determining treatment and the nature of potential complications. Each area of the brain manages extremely specific tasks and an injury can alter or interrupt our ability to perform these tasks. A change of even a few inches can drastically alter the entire nature of the injury.
The Frontal Lobe is responsible for higher brain functions like problem-solving, memory, or the ability to focus your attention. It also controls emotions, judgement, impulse control, and social or sexual behavior. Even the difference between right and left lobes can be dramatic as the right-side controls more non-verbal abilities and the left-side houses much of our language skills. The comparatively large size of the frontal lobe and its location in the front part of the cranium make it more susceptible to injury. Injuries to either frontal lobe can dramatically affect many of the so-called ‘executive’ functions of the brain. Executive functions include advanced cognitive processes like reasoning or problem-solving.
The temporal lobes are located about ear level on each side of the brain and are the main centers for both long- and short-term memory. The right side is involved more with visual memory and allows us to recognize objects. The left side focuses on verbal memory and helps to remember and understand language. The rear area of both sides helps us to interpret the emotions and reactions of others. Injuries to the temporal lobes can affect memory or drastically affect a person’s ability to effectively communicate.
The occipital lobe resides in the lower back of the brain and is primarily responsible for processing visual information from the eyes. Much of our ability to recognize shapes and understand ‘what’ it is we see is focused here in the occipital lobe. Damage to the area can leave a person blind, or with difficulty identifying the size and shape of objects.
The upper back part of the brain is called the parietal lobe. This lobe controls movement and our sense of touch. It also handles integrating the signals from various parts of the brain to help us perceive and make sense of the people, places, and things around us. An injury to this area can affect our spatial awareness and how effectively we process information from our primary senses.
The cerebellum is found just above the brain stem toward the back of the skull. Its placement gives more protection from trauma compared to the other lobes. The coordination of voluntary movement, balance, and equilibrium are controlled by the cerebellum. An injury here can affect the victim’s ability to stand, walk, or effective use of their hands.
Located at the lower middle of the brain is the brain stem. This vital area is attached directly to our spinal cord and serves as the conduit for coordinating signals sent between the brain and the body. The brain stem also regulates life-supporting autonomic functions like your heartbeat, breathing, and digestion. Injuries to this area typically will not have cognitive effects, however, are often serious and life threatening due to its delicate nature and sensitive location.
Possibility of Serious Health Complications
Traumatic brain injuries can leave the victim susceptible to a number of serious health complications. These complications can make recovery and treatment even more difficult.
Seizures are a sudden, uncontrolled electrical disturbance in the brain. They can range from a short period of staring or confusion to longer seizures with a loss of consciousness and jerking movements of the arms and legs. Any seizure that lasts for 5 minutes is an acute medical emergency. Repeated seizures more than a week after the initial injury is called post-traumatic epilepsy.
Hydrocephalus occurs when fluid builds up in the ventricles deep within the brain itself. This dangerous build up puts pressure on the brain and if left unchecked can result in severe damage and impairment. In serious cases surgery is needed to insert a shunt into the brain to allow the cerebrospinal fluid to drain into another part of the body. This shunt typically is not removed and will require regular checkups going forward.
Various stages of altered consciousness are possible following a traumatic brain injury. In a minimally conscious state, the victim may still have limited awareness of their surroundings and may respond to simple yes or no questions. A vegetative state leaves the victim unaware of their surroundings but may still have some reflex responses or periods of unresponsive alertness. A person in a coma is unable to respond to external stimuli, is unconscious and unaware of their surroundings. In severe cases where there is no measurable brain function for an extended period of time, the victim is pronounced brain dead.
Meningitis is the inflammation of the fluid and membranes surrounding the spinal cord and brain. Although most cases of meningitis are from a viral infection, introduction of bacteria from a TBI can also trigger this serious condition. Bacterial meningitis must be aggressively treated with antibiotics right away, as otherwise it can prove to be fatal in just a few days.
The Effects of a TBI on the Quality of Life
More so than any other type of injury, the effects of a traumatic brain injury can strike at the very essence of what makes us who we are. Tragically, these changes often affect not only the victim, but also have a dramatic impact on family, friends, work, and the community at large.
Impact at work
The amount of time someone will need to take off from work depends on the extent of the injury and treatment requirements. The nature of the job will certainly play a significant role in determining when a doctor will clear a victim of a TBI to return to work. In some circumstances it may be difficult or impossible to return to the same type of work the victim had pre-injury.
Those able to return to work will often need some accommodations from their employer. Requests for a lightened workload, added breaks, and shorter hours are common. Some physical symptoms may require changes to job environment or duties in general. In the long term, a greater flexibility in the use of and allowance of personal or sick time is beneficial in making the transition back to work fully successful.
Changes to personal life
Physical and ability changes can force the altering of day-to-day routines. Emotional and cognitive changes often prove more challenging to adopt to, not only for the patient but their support system too. Depression, anxiety, and other psychological difficulties are unfortunately common. Research suggests that over half of patients with a TBI experience some form of emotional or behavioral difficulties stemming from the injury.
The inability for the patient to understand the nature of their impairment complicates the matter. A lack of self-control and reduced self-awareness lends itself to acting impulsively or behaving inappropriately. Individuals may say hurtful or insensitive things or behave inconsiderately. Reduced awareness of appropriate boundaries or others’ feelings means they often do not realize when they are making others uncomfortable.
Society at large
The long-term effects of a TBI can undermine an individual’s ability to participate in and enjoy many of the social activities we take for granted. In addition to any physical challenges, trips to locations or events that were once cherished are now be filled with anxiety and uneasiness. Emotional impairment from a TBI makes connecting with people a challenge. This awkwardness can lead to isolation furthering the cycle of depression, anxiety, and emotional disturbances.
Litigating a TBI Injury in Wyoming
Medical treatment for a traumatic brain injury has the potential to be a complex and often long-term process. Effectively litigating a claim for TBI poses its own unique challenges.
A mild concussion is a serious injury potentially causing a litany of symptoms. However, in practice, such injuries are frequently more challenging to prove in court than other types of injuries. When the direct medical evidence like diagnostic imaging is not clear-cut, it will be up the victim’s attorney to show conclusively the cause and effect. Anytime a jury is unable to easily see the damage and quickly grasp the connection to a specific effect on the person’s life, the burden will be to coordinate sufficient evidence and testimony for them to make that connection.
For more a more serious TBI, one of the challenges will be to work hard to encompass all the ways this injury has affected the victim. The use of expert witnesses to interpret medical reports and testimony from family or friends about changes to the victim are common examples of the types of evidence used to substantiate a claim. Certain aspects of the damages like medical bills are easily calculated. The subtler aspects of the claim pertaining to changes in quality-of-life issues present more of a challenge. Retaining an experienced attorney who specializes in representing victims of a TBI is an important step in protecting your interests.
Since 1993, The Advocates have been one of the top personal injury law firms in the Western United States. Our experience representing victims of a traumatic brain injury is unparalleled. Our attorneys know what it takes to build you an iron-clad case. Our high level of expertise means we can build you a winning case capable of obtaining maximum compensation for the injuries and losses you’ve suffered. Don’t wait! For a free case evaluation with an Advocate attorney call our office today at (307) 466-0003, fill out the form below, or you can chat with an attorney from the bottom of your screen. Your case deserves an Advocate!