Brain Injury Basics: What Is Cognitive Rehab?

Cognitive problems are the most common lingering symptoms of those who have made a good recovery from a traumatic brain injury.  Fortunately, cognitive rehabilitation can at least help reduce some of these problems.

Cognitive rehabilitation is training for the brain and for the victim of a brain injury.  Depending on the extent of your brain injury, cognitive rehab can help repair your brain’s neurological connections so that you can function at a higher level, or it can train you how to function with your limitations.

Some cognitive rehabilitation processes focus on retraining your entire brain.  In these, you might undergo repeated exercises doing the same thing over and over.  While these are necessarily repetitive, they are designed to reorganize your brain’s “wiring” so that the brain is more functional across a number of different areas.

Some cognitive rehab processes focus only on certain skills that are giving you problems.  For example, if your brain injury causes you problems with drinking out of  cup, you will undergo specific training to help you re-learn how to use a cup.  Alternatively, if it is too difficult to re-learn how to use a cup, you might be trained in alternatives, such as easily using a straw.

Because attention deficit and memory issues are the two most common symptoms of brain injuries, there are a number of different cognitive therapy procedures that can be used to help you improve in these areas.  In a typical situation, you would undergo exercises designed to re-train your brain, as described earlier.  You might also receive training in how to use memory strategies, such as mnemonic training (mnemonic’s are learning/memory aids — such as the old Roy G Biv we all learned to remember that Red, Orange, Yellow, Green, Blue, Indigo and Violet were the colors of the rainbow). You would receive training to teach you how to create and use these type of memory aids in a number of different areas of your life.   Memory training might also include learning how to use external cues — things that are designed to remind you of other tasks — or learning how to use a “memory notebook” — to journal things you are supposed to remember in the future.

Fortunately, studies have shown that a holistic approach that incorporates a number of different types of cognitive rehab processes can help you improve on your brain function, though most studies show that even with the best cognitive rehabilitation, victims of traumatic brain injuries still show problems.

Unfortunately, cognitive rehabilitation is very expensive.  In a 2009 letter to the United States Congressional Budget Office officials, the president of the Brain Injury Association of America estimated that the average cost of cognitive rehabilitation was $27,000.00.

If you want to learn more about cognitive rehab, additional resources are available:

 

 

Brain Injury Basics: Neuropsychological Testing

If you have suffered a brain injury, you might be referred to a neuropsychologist, who will often recommend neuropsychological testing.

A neuropsychologist is a psychiatrist with a specialty in the science of brain-behavior relationships.  In other words, they deal with how brain function affects your behavior.   The neuropsychologist uses a number of methods, including neuropsychological testing, to evaluate your injury.

Neuropsychological exams usually consist of a series of questions about your condition.  Some tests may be brief, but some may be much more detailed, taking up to a full day.

The test results are used for a number of different purposes.   Depending on the need, the purposes may include (1) diagnosis of an injury; (2) patient care and planning; (3) treatment; (4) evaluation of treatment; (5) research; and (6) forensic neuropsychology — for use in litigation and lawsuits.

For personal injury purposes, we’re interested in all of those categories.  We’re interested in 1-4 to make sure you get better and get the care you need, and we also seek a forensic evaluation for your case.  In the litigation context, the neuropsychologist can help confirm you have a brain injury, document the extent of your injury, evaluate your future course of treatment, and provide opinions about your recovery, both in terms of your daily activities and your work life.

Brain Injury Basics: Brain Injuries In Children

Brain injuries are devastating in children.

Today, traumatic brain injuries remain the leading cause of both death in children.

For those children lucky enough to survive, an early brain injury can have life-long consequences.  Brain injuries often affect a child’s ability to learn even years after the injury.   Young victims are particularly vulnerable because most brain development occurs between the ages of 1 and 5.  Even as children get older, studies still suggest that the younger they are at the time of injury, the more serious problems they will face.

And even when a child has a satisfactory or normal IQ levels, emotional problems caused by the head injury set them back.  One study found that 19 of 22 children with  brain injuries showed long-term emotional issues.

These problems have a real economic value.  One study found that only 27 percent of kids who sustained brain injuries were working full-time by the time they reached age 21.

Unfortunately, auto accidents are the leading cause of brain injury-related deaths in children.  Proper use of seat belts and car seats can really help minimize these risks.

Falls still account for most brain injuries in children, including falling down stairs, falling off of playground equipment, and falling out windows.  Parents can help reduce the risk for these types of injuries by child-proofing the house and making sure that playgrounds are protected by twelve inches of soft surface material (such as mulch, gravel,  etc.)

Bicycle accidents also account for thousands of brain injuries per year.  Parents can reduce the risk of bicycle-related brain injuries by teaching their children bicycle safety and making sure that children are properly using bicycle helmets.

 

 

Brain Injury Basics: Causes of Brain Injuries

A common argument that we hear from insurance companies is that our client’s brain injury couldn’t have been caused by the accident because the client’s head didn’t hit anything.  That is a fallacy.    It is true that most head injuries are caused by a trauma to the head.  For example, in a car wreck, the victim’s head may hit the window, the steering wheel or the dash board.  However, there are a number of other common situations that lead to brain injuries where there aren’t any direct blows to the head.  Some of those are listed below.

1.  Forces applied to the brain.   You don’t have to hit your head to apply forces to the brain.  When your head moves rapidly, your brain moves inside your skull and impacts the brain.  These forces, slamming your brain around in your skull, are often hard enough to cause brain injuries.  For example, one study found that in car wrecks of 35 miles per hour, 27% of drivers and 21% of passengers who were wearing seat belts were at high risk of head injury even when their head didn’t contact anything on the interior of the car.

This risk is often made worse because multiple impacts occur.  Studies have repeatedly shown that repeated brain injuries have a cumulative effect on people, and in high impact accidents, there are often multiple injuries.  For example, in a simple rear-end case, upon impact, the head is immediately thrown forward, causing the brain to hit the front of the skull.  And then the head whips back, causing a second impact with the back of the skull.  With more complications, such as impacts with other cars or quick stops, there are additional opportunities for more impacts and more injuries, all occurring without the head ever hitting anything on the interior of the car.

Even hearing the above description, some may discount the non-impact cause of head injuries.  But remind them of shaken-baby syndrome.  Countless children are harmed or even killed from head injuries suffered by shaking — and they all occur without any impact.

2. Blast Injuries.  One legacy of the Iraq war is that we are learning more and more that people around explosions can suffer severe brain injuries without any type of impact on the head.  These same type of injuries are often found in construction-site accidents or in various types of manufacturing plant accidents.

3.  Lack of Oxygen.  Brain injuries are also often caused by anoxia, or lack of oxygen to the brain.  These types of injuries often occur in near-drowning cases, but they also arise in other situations.

4.  Loss of Blood.  An injured person who loses a lot of blood may also develop a brain injury even though the head never impacted anything during the actual accident.

5.  Electrical Injuries.   Many doctors miss this, but any type of electrical injury can potentially cause a brain injury in a person.

Just because you or a loved one doesn’t have an impact on your head, don’t dismiss the possibility of a brain injury.  Recognizing the brain injury and getting prompt treatment can make a difference in your outcome.

Brain Injury Basics: Symptoms of Brain Injuries

If you think you or a loved one has sustained a head injury, it’s critical to know potential symptoms of brain injuries.

Knowing the symptoms can help you understand when a brain injury is possible so that you know to speak to your doctor about it.  A 2003 Centers For Disease Control report to Congress noted that in many instances, persons with mild traumatic brain injuries fail to timely seek medical care because they don’t recognize their symptoms. Even worse, the report notes that once care is sought, many medical providers still fail to diagnose the head injury or recognize the severity of the brain injury.  Knowing the symptoms of brain injury and looking for them in yourself or your spouse can help make sure a diagnoses is made as soon as possible.

Knowing the symptoms can also help you understand what you or your loved one is going through.  Often, a spouse or loved one will become frustrated with the way injured person’s conduct.  In those situations, it’s important to understand the symptoms of brain injuries and to know that the injured isn’t choosing to act that way.  Instead, the injured has a serious condition with serious consequences and needs to get medical care.

There are literally thousands of potential symptoms of head injuries.  If you come to our office with a potential head injury, you will be given a form that asks you about the following symptoms, which we commonly see in brain injury cases:

  • Headaches
  • Feelings of dizziness
  • Nausea and/or vomiting
  • Noise sensitivity (easily upset by loud noise)
  • Sleep disturbance
  • Fatigue/tiring more easily
  • Irritability
  • Feeling depressed or tearful
  • Feeling frustrated or impatient
  • Forgetfulness/poor memory
  • Poor concentration
  • Processing issues/taking longer to think
  • Blurred vision
  • Light sensitivity
  • Double vision
  • Restlessness
  • Reading problems
  • Writing problems (writing letters out of order, etc.)
  • Word recall/inability to remember words, names or numbers

If you have a head injury, you’re not likely to have all of these symptoms.  Most people only have 2-3, and many only have one.  What is important is to know the symptoms and look out for them following a wreck or other event.

Doctors had long thought that in cases of mild injuries these symptoms would slowly disappear as the brain heals.  But new research is beginning to reveal that even mild brain injuries can have permanent damage and be related to long-lasting symptoms.  For example, in the summer of 2012, a new study of brain injured veterans (and sadly, our veterans are now suffering too many brain injuries) found that symptoms of post-concussion syndrome can last for years.   This and other studies are confirming what we see in our practice — even the most “minor” brain injuries can last a life-time.

 

 

Brain Injury Basics — New Series

Over the years, we’ve been fortunate to help a number of clients who have suffered brain injuries in various types of accidents.  After speaking to some recent clients, one of their biggest frustrations is that it’s difficult to find easy to understand information about brain injuries, brain injury treatment, and brain injury prognosis.  As a result, we’ve spent a good amount of time trying to help them find accurate, easy-to-understand information.

Over the next few weeks, I’ll be writing a series of blog posts that try to give some basic information.

Keep in mind, this isn’t medical advice, and patients with brain injuries, more than anyone else, should get the help they need as quick as they can.  But I maintain that people who know more about their condition and their case, make better decisions and get better results.

I also think the information is particularly important in head injury cases.  Sometimes doctors are slow to diagnose head injuries because the doctors don’t know you well enough to compare your condition after the wreck to your condition before the wreck.  Therefore, it’s important for you, your friends and family members to know the symptoms of head injuries and potential causes of head injuries to help with the diagnosis process.

Sports Injury Lawsuits: Another Lawsuit Filed Against The NFL Related To Concussions & Painkillers

A dozen former National Football League players have filed a personal injury suit against the NFL and others for allegedly overusing the painkiller Toradol.  The lawsuit alleges that teams and trainers were regularly dispensing the medication, which made it difficult to know when players had sustained serious injuries, including concussions.  The emphasis is on concussions and the long-term effects of concussions on the league’s players.  The specific allegations are that the players have residual concussion symptoms, including anxiety, depression, memory loss, severe headaches, sleeplessness, and dizziness.

This story serves as a reminder for several lessons.  First, it is again a reminder that in sports there are many injuries that aren’t just accidents.  While some injuries are unavoidable, teams owe duties to players to take reasonable precautions to make sure the players are safe.  That means not overly medicating them, not forcing them to practice in unreasonably hot or dangerous conditions, etc.

Additionally, the story is a reminder about the danger of concussions.  I feel like I’m on a one-man crusade on this blog, but car wreck and other injury victims need to be on the lookout for symptoms of concussions.  They are sometimes difficult to diagnose, but they can have long-term health consequences.

If you or a loved one has been injured in a sports-related incident or have suffered a concussion in an accident caused by the negligence of others, please give us a call, and we’ll do our best to help you out.

What Personal Injury Victims Can Learn From The Military’s Brain Injury Debacle

The lasting legacy of the Iraq and Afghanistan wars will be the amazing number of head injuries suffered by our troops.

Yesterday, NPR released a report detailing ways that we are failing those injured.  One key component of the report was failed testing and diagnoses for the injuries. 

The United States has spent $42 million trying to adminster test to members of the military to diagnose whether they have suffered any kind of traumatic brain injury.  In theory, the program should work great.  Every member is tested before deployment and then upon return from depoloyment,  That way, the original tests can serve as a baseline to determine where the military member was before entering the conflict.

But it hasn’t worked out well.  From the report:

We have failed. We have failed soldiers,” says retired Col. Mary Lopez, who used to run the Army’s testing program. She still works with soldiers in Germany. “It is incredibly frustrating because I can see firsthand the soldiers that we’ve missed, the soldiers that have not been treated, not been identified, misdiagnosed. And then they struggle.

The story about how the military got where it is, why they chose the test they did, etc are all interesting, but not what I want to write about today.

Instead, I think personal injury victims can learn from Col. Lopez’s summation — brain injuries are difficult to diagnose and when undiagnosed, the injured don’t get the help they need and then have problems.

That is a lesson that is important for those injured in almost every type of injury claim.  Brain injuries from car wrecks or other accidents are hard to diagnose.  Most of the time, doctors aren’t looking for brain injuries, and doctors usually don’t know their patients well enough to tell if there is a difference in the patient after an incident.

And if the doctors don’t make that diagnose, then the injured don’t get help.

That’s why I always tell my clients to be on the lookout for head injuries.  Often, you or a loved one will be the only ones who notice that you have memory issues or a changed personality.  So it’s important for you to look out for the symptoms.

It’s also important to get the help you need.  When the head injury is severe, there are a number of different forms of cognitive therapies that you can undergo, but the problem has to be diagnosed first.

Concussions, Head Injuries, Football Season & Cheerleading — they all go together

This may sound hokey, but I’m a believer in “signs.”  If we pay attention to things, someone upstairs might be trying to tell us something.

Today, the “signs” are saying I need to write  something about the increasing problems of head injuries and concussions that we’re seeing not only in football, but also in cheerleading.  Why do I say that?  One of the articles that caught my eye in this morning’s Austin American Statesman was a story about the increasing number of concussion and head-injury related lawsuits by former NFL players suing the NFL and helmet manufacturers, primarily Riddel. 

And then, one of the first telephone calls I received this morning was from a safety advocate in Arkansas who called me asking about head injury issues in football and cheerleading.

At this point, I’ve written fairly extensively about the dangers faced by football players and that one way to help minimize that danger is making sure your kids have a proper helmet.  You can read some of those pieces below:

However, I haven’t written as much about the dangers of cheerleading.  In fact, cheerleading is one of the leading causes of injuries to young girls.  I sent the safety advocate links to a few resources about the problem.  The articles included:

I hope this information is useful to someone and helps protect a kid or two.

Protect Your Child From Concussions Or Head Injuries With A Proper Football Helmet

Football season….it reminds me of the Christmas Song…”It’s The Most Wonderful Time Of The Year.”

While each football season brings excitement, camaraderie, and fun, it also brings new cases of head injuries or concussions. 

And for some reason, football related head injuries and concussions have been in the news lately.  Just this week, several former NFL players, including Jim McMahon, sued the NFL and others about the link between concussions and football.  And just a couple of months ago, I wrote a post about new studies showing a link between football-related brain injuries and dementia

The one thing about all these stories is that it makes parents and players aware — and that awareness is good.  While you’ll never be able to eliminate the risk of head injuries and concussions in football, there are some precautions that you can do to minimize the risk.  For example, Virginia Tech University has been doing excellent research on the safety of football helmets.  They have recently released a website showing the findings of those studies, including listing the helmets that they think best minimize the risk of football-related head injuries.

If you have a child participating in football, take a few minutes to look at these and other resources that can help inform you about the risks of concussions.  Those few minutes, and the resulting action, could help your child for years into the future.

Posted on: August 22, 2011 | Tagged

Perlmutter & Schuelke, LLP 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

Website by SEO | Law Firm™, an Adviatech Company