Brain Injuries: New Study Finds Fewer People Recover From Post-Concussive Syndrome

The April 2017 issue of the Journal of Neurotrauma reports on a new study about post-concussion syndrome.

The study followed 110 patients who had post-concussive syndrome symptoms for more than three months, and the findings were stunning.  Of those patients, only 27% made a full recovery.  Of the 27% who made a recovery, 67% made a recovery within the first year.  And no one who had symptoms over three years ever made a recovery.

For those groups that didn’t recover, the continuing symptoms (in order of frequency) were:

  • Headache
  • Difficulty concentrating
  • Fatigue
  • Dazed/don’t feel right/in a fog
  • Pressure in the head
  • Sensitivity to light
  • Difficulty remembering events
  • Neck pain
  • Sensitivity to noise
  • Depression/sadness
  • Insomnia/sleep disturbance
  • Irritability
  • Anxiety
  • Frustration
  • Feeling slowed down
  • Noise in the ears
  • Vision changes
  • Lightheadedness
  • Imbalance
  • More emotional
  • Dizziness
  • Nausea
  • Increased sensitivity to alcohol
  • Confusion
  • Personality changes
  • Vivid dreams
  • Numbness
  • Vertigo
  • Panic attacks
  • Disorientation
  • Stomach ache
  • Loss of appetite
  • Slurred speech
  • Seizures
  • Vomiting

These findings are significant to our brain injury cases.

Most insurance companies argue that brain injuries typically heal themselves and symptoms disappear after six months or a year. The insurance companies use that argument to reduce the value of the claim.

This study refutes that.  If a client has had symptoms lasting more than three months, then this study is evidence that the client will likely never make a full recovery.   Obviously, if an injury is permanent then the value of the case is higher.

The study is also interesting because it has a good list of symptoms of a brain injury.  It’s important for people to know these symptoms to help them recognize when they might have a brain injury.

Another interesting fact was the distribution of the symptoms.  Generally, post concussion syndrome has three classes of symptoms:

  1. Cognitive symptoms — affect your thinking
  2. Affective symptoms — affect your mood (depression, irritability, etc)
  3. Somatic symptoms — separate symptoms (headaches, light sensitivity, etc).

The study found that the persisting symptoms were quite evenly distributed between the three classes of symptoms.

 

 

My MRI or CT Scan Was Negative. Does This Mean I Don’t Have A Brain Injury?

This is another question I’ve recently received from potential clients.  They were involved in an incident — a car wreck, a slip and fall, or something similar.  They went to the ER, and the ER performed an MRI or a CT san looking for problems, but scan came back negative.  Does this mean that the was no brain injury?

Absolutely not.

While an MRI or a CT scan can find some brain bleeds or some damage, they don’t find most problems.  As a result, the vast majority of people who have brain injuries have a normal (what we call negative) MRI or CT scan.

Indeed, while insurance companies sometimes try to argue about claims when you have a normal MRI or CT scan, virtually all scientific literature and all neurologists agree that you can still have a normal scan.  Not only that, virtually all neurologists will agree that most of the patients they see for brain injuries have normal scans.

So if you feel like you’re off or your family members are telling you that you’re different after a car wreck, a fall, or another event, don’t rule out a possible brain injury just because you had a normal CT scan or MRI.  You may very well still have a mild traumatic brain injury that needs to be treated

The Emergency Room Didn’t Say Anything About A Concussion. Does That Mean I Don’t Have A Brain Injury?

This is a question I’ve seemed to be answering for clients lately.  You are in a wreck or other event.  You go to the emergency room.  They look you over, they never say anything about a brain injury, and they send you home.  Does this mean you don’t have some type of brain injury?

Absolutely not.

Emergency rooms (and even other doctors) are notoriously bad at diagnosing brain injuries.  Why is that?

First, emergency rooms are triage facilities.  They are only really looking for the things that are life-threatening or need to be treated immediately.  Too often, this means that they don’t look for brain injuries unless the brain injury is the type that’s completely obvious.

Second, emergency rooms (and most other doctors) don’t know you.  For the most part, there’s not a readily available test that we can use during a doctor’s visit to say whether you have a brain injury.  The first time a brain injury is diagnosed is usually based on your complaints of your symptoms and comparisons of how you were before you got hurt to how you are after you got hurt.  Doctors can compare your symptoms to common brain injury symptoms, but the doctors have to be looking to put two and two together.  And doctors usually don’t know you well enough to compare your condition from before the wreck to your condition after the wreck.  As a result, it’s often difficult for a doctor to make the diagnoses of a brain injury.

That’s why I tell clients that it’s so important to have friends and family members look for changes in your condition or behavior.  For our clients, we have forms that we give you to fill out that can help figure out what problems you’re having.  That way, you’ll be in a better position to articulate to your doctor the problems you’re having and the doctor can more easily and quickly make a referral to a neurologist or other treating physician.

Don’t Let GEICO Or Other Insurance Companies Take Advantage Of You After A Car Wreck

Insurance claim forme

Here are today’s two lessons from a court decision yesterday:  (1) Take your time before settling your case.  (2) Talk to a lawyer before settling a case.

I often warn victims of car wrecks or other accidents to be aware of insurance companies’ “swoop and settle” tactics.  In these situations, the insurance company (GEICO seems to be the worst) contacts you immediately after a wreck and makes an immediate settlement offer to try to get you to give up your rights before you know how bad you are hurt or before you know your rights.

Yesterday, the Dallas Court of Appeals handed down a new case that shows just how this terrible practice works.

In the case, Windell Gilbert was injured in a car wreck.  GEICO was the insurance company that covered the driver who caused the wreck.

Eight days after the wreck, GEICO called and suggested to Mr. Gilbert that they settle the case for GEICO’s payment of the medical expenses incurred on the date of the accident (which totaled $4,806.75) and $500.00 to Mr. Gilbert.  Mr. Gilbert agreed, and the GEICO representative had them do a recorded call confirming that settlement.

Not surprisingly, but Mr. Gilbert ended up being hurt much worse than he thought.  He went to a doctor and had over $15,000.00 more in medical expenses.

Mr. Gilbert later sued the other driving, arguing that the first settlement was unfair.  But yesterday’s opinion held that Mr. Gilbert and GEICO had a binding agreement and that Mr. Gilbert was bound to the $500.00 agreement.  Moreover, the court awarded GEICO (through the other driver) $10,000.00 in attorneys’ fees against Mr. Gilbert.

This case is a perfect example of why car wreck victims should wait to talk to an attorney and to take a little time before settling a case.  Initially, even if Mr. Gilbert wasn’t hurt more than just needing medical care on the first day, the offer from GEICO was a terrible offer.  But more importantly, people are often hurt more than they realize.  Problems linger or don’t show up until later.  I typically advise my clients that in most cases, you shouldn’t settle until you know you’re better or until a doctor tells you you’re not better, but you’re as good as you’re going to get.

So remember the lessons for car wreck (and really all injury) claims. Don’t settle too early, and don’t settle without talking to a personal injury lawyer.

 

 

Energy Drinks Linked To Brain Injuries

brainA new University of Toronto study found that teenagers who drink heavily caffeinated energy drinks are more prone to traumatic brain injuries.

In the firm, I see brain injuries in all sorts of situations — car wrecks, bicycle accidents, falls, etc.  But for teenagers, the most common cause of traumatic brain injuries is sports.  The rate of brain injuries in teens has been on a rise (in part, I think, because of better diagnoses).

The new study sheds some additional light on the problem.  The researchers interviewed 10,000 people from ages 11-20 and asked a series of questions, including questions about usage of energy drinks and their incidents of brain injuries.  The results were startling.

Those kids who had consumed one energy drink in the last year were twice as likely to have suffered a brain injury and non-drinkers, and those kids who consumed five or more energy drinks in the last week were nearly seven times more likely to have sustained a brain injury.

These results don’t necessarily show that the use of energy drinks makes a person more likely to suffer a brain injury from an event.  But it’s possible.  The high caffeine levels affect the brain in ways that we don’t know, and the caffeine levels could make the brain more susceptible to injury.  More study is needed there.

Alternatively, there is some thought that there is a correlation between the use of energy drinks and high risk behavior.  Maybe people who drink energy drinks engage in activities that are more dangerous than what a typical kid experiences.

Finally, there is the possibility that the use of energy drinks is a coping mechanism to deal with the after-effects of brain injuries.  Many kids with brain injuries describe themselves as being tired or in a fog.  Perhaps the usage of energy drinks is a way to fight off those symptoms.

There is still a lot to learn on these topics, but there is enough concern that I think we should discourage the use of these energy drinks by kids until we know that they’re safe.

Austin Dog Bites Are Increasing

Beware of dog sign.Last week, the Austin American Statesman reported that dog attacks are increasing in Austin.  The number of dog attacks has increased every year since 2007.  This year is no exception.  Austin has experienced over 1,000 attacks so far, on pace to break last year’s record.

These are not good statistics.  I’ve represented a number of victims of dog attacks, ranging from the run-of-the-mill attacks to a horrific case where a dog attacked and killed a young child.

These are often terrible cases for those involved.  With aggressive dogs, there is usually significant pain and trauma relating to the original attack.  Many serious attacks have long-term physical consequences, including physical limitations and scarring.  And almost all involve permanent psychological scarring.

Legally, there are a number of different avenues of claims that may be made.  The obvious claim stemming from a dog attack is against the dog owner.  In Texas, dog owners have various responsibilities to help protect the public from unsafe dogs.

If the dog owner was a renter, there may be a claim against the home or apartment owner, depending on the specific facts of the attack.  Additionally, if the dog owner was a renter and a property management company was involved, the property management company also has duties and responsibilities that it must follow.

The more difficult situation in these cases is finding funds for a recovery.  Traditionally, homeowners’ insurance companies have provided coverage for these claims.  Now, as insurance companies are becoming more aware of how serious these claims are, many companies are starting to exclude coverage for dog attack claims.  This is important information to know not only for the victim of attack, but also for dog owners.  If you own a dog, talk to your insurance company and make sure that you’re covered should something go wrong.

 

If you or a loved one has been injured in a dog attack, please call us for help at (512)476-4944.

 

The Failure of Tort Reform

Steve Cohen has an interesting article, On Tort Reform, It’s Time To Declare Victory and Withdraw, detailing the failings of tort reform in the medical malpractice context.  In his article, Steve outlines some of the things we’ve learned since tort reform started passing in waves, including in Texas:

1) Tort reform hasn’t decreased healthcare costs.  The theory was that doctors afraid of getting sued were prescribing all kinds of unnecessary tests.  In fact, studies have shown that doctors in states that have enacted tort reform measures prescribe tests at the same rate as those that haven’t had tort reform measures.

2) Runaway juries aren’t a real problem.  Indeed, the data suggests that the average jury awards in medical malpractice cases are significantly lower than the average awards handed down by judges.  If anything, juries are conservative on these cases.

3) Tort reform hasn’t significantly decreased the cost of insurance for doctors, though in states with tort reform measures the increases in rates have been slightly lower than the increases in states without tort reform.

What has happened since tort reform?  Insurance company profits have skyrocketed.  That’s who has really benefited from tort reform.

Unfortunately, in Texas and other states, while trying to craft tort reform for medical malpractice cases, the reforms have bled into other areas of claims, and have hurt the rights of most injured persons and businesses.

With tort reform proven to be a failure, it’s time to make sure it stops.

What Will It Take To Get A State-Wide Ban On Texting While Driving?

Earlier this week, families who have been destroyed by texting while driving wrecks came to Austin to urge state lawmakers to adopt a state-wide texting while driving ban.  Unfortunately, they’re not alone.  Stories like those shared by these families have been repeated over and over and over.

There is no dispute that texting while driving is dangerous.  Studies have even shown that it’s more dangerous than drinking while driving.  You would think that a state-wide ban would be a no-brainer.

But apparently it’s not.  Some legislators argue that a ban would be an unnecessary invasion into people’s rights.  Are you kidding me?  Is the speed limit an unnecessary invasion?  Are laws against DWI an unnecessary invasion?  Texting while driving is just as dangerous, if not more dangerous, and we need to be doing what we can to protect our kids and families.  Will a ban stop texting while driving?  No.  But it will help, and that’s better than nothing.

You should watch the stories of these families below.

 

Vanishing Lawsuits and Jury Trials

Warrior Award 2015The statistics from the Texas State Office of Court Administration are startling.  In the last ten years, the number of lawsuits having been filed has dropped 17%.  At the same time, the number of civil jury trials have dropped 34%.

What’s that mean for you?

It makes a difference when you’re hiring a lawyer.

The reality is that while the number of “litigation” lawyers or “trial lawyers” have been on the rise, the actual number of lawyers who have actually participated in a jury trial has been plummeting.  Lawyers calling themselves “litigators” may file lawsuits and do discovery and go through alternative dispute resolution and settle cases, but most rarely, if ever, see a jury.

A recent Texas Bar Journal reported on a survey of lawyers who called themselves litigators.  Of those with ten years of experience, 30 percent had NEVER tried a case to a jury.  And perhaps even more remarkable, only 36 had tried two or more cases to a jury.  That means that almost one third of the lawyers calling themselves litigators had never had a jury trial and another third had only had one trial.

Unfortunately, when you’re hiring a lawyer, you may never know whether the lawyer has ever tried a case or whether the lawyer has ultimate plans to just settle your claims.  This can often affect the ultimate recovery that you make.

Some of us are trying to do something about it.  I’m proud to be an active member of the Capital Area Trial Lawyers’ Association (I’m the immediate past president).  We have started giving out a “Warrior Award” to our members who take cases to jury trials.  This is a way of acknowledging those of us who have actually tried cases, and a way to encourage other lawyers to take their cases to trial.  We have also started a system where lawyers help one another with voir dire or other parts of the case to make trying cases a little easier.

I certainly don’t think our system will change the face of the state’s lawsuits, but I do hope it can help provide better representation for injured persons throughout Central Texas.

 

Brain Injury Symptoms: Speech and Language Problems

The human brainAs I repeatedly tell clients, brain injuries often go undiagnosed following car wrecks or other accidents because doctors don’t usually know you well enough to make a pre-injury and post-injury comparison of your intelligence, emotional well-being, and general personality.  As a result, it’s often up to you or your family members to notice the symptoms of a brain injury and convey those to medical providers so you get the best care possible.  But to do that, you need to know the symptoms of brain injuries.  This series is designed to help you do that.

Unfortunately,  brain injuries often affect a victim’s ability to communicate.  These are not only scary problems to encounter, but they can greatly affect the victim’s quality of life going forward.  Some of these issues are as follows:

Cognitive issues.  Many victims find their communication problems resulting from cognitive issues such as problems with word recall, inability to tell stories or other thoughts in sequence, or difficulty understanding more complex thoughts or expressions.  There are often some coping strategies that can be used to help with these problems.

Slurring or other speech problems. Another common problem is slurring of speech.  Technically, brain injury patients can develop a motor speech disorder called dysarthia.  The symptoms of dysarthia may be slurred or choppy speech, slow rate of speech, inability to fully move mouth, tongue and jaw, and other changes in voice quality.  These are obviously scary problems, but they can often be treated with speech therapy.

Swallowing problems.  Though not a true communication problem, a somewhat related symptom is swallowing problems.  Many victims of head injury develop issues with swallowing.  This is obviously not a symptom that you would normally associate with brain injuries, but it is one that you can easily recognize if you’re looking for it.

Perlmutter & Schuelke, PLLC maintains offices in Austin, Texas. However, our attorneys and lawyers represent clients throughout the state of Texas, including Dallas, Houston, San Antonio, Forth Worth, El Paso, New Braunfels, San Marcos, Kyle, Buda, Round Rock, Georgetown, Lockhart, Bastrop, Elgin, Manor, Brenham, Cedar Park, Burnet, Marble Falls, Temple and Killeen. By Brooks Schuelke


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