Proving the Effects of a Concussion in Mild Traumatic Brain Injury Can Be a Challenge

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Concussion is brain injury Concussion is Brain injury

Proving the effects of an isolated concussion, especially where there were no findings on MRI or CT scan can be a challenge. Even proof of repeated concussions and the connection to long term symptoms can be problematical as the recent settlement by the NFL and injured players implies.


What Does The NFL Players Concussion Brain Injury Settlement Mean

Melissa Healey writing for he Los Angeles Times is of the opinion that the $765,000 million dollar settlement among 4,500 retired players and the National Football League " underscores two key facts: that it (brain injury) is difficult to prove and measure - especially after the fact - and that its link to neurocognitive problems that appear years later remains an enigma. (1)

There is conflict amount neuropsychologists whether one concussion can cause long term effects. ( Lasting over three months) My take on this is there is bias in the profession that studies these phenomena.  I had two personal injury clients that were incidentally tested by the same neuropsychologist. Although there were findings on test results  that showed a change from preinjury to post injury cognitive function, these were either found to be so small as to be insignificant or that the change was due to some other factor.

The statement was also flat out made that one concussion with out evidence of significant loss of consciouness or brain injury on CT scan or MRI could not cause long term effects. When I asked another psychologist to comment he said it could be due to bias of the examiner. Too many professionals believe that people injured by the fault of others have secondary gain and are unwilling except in the most obvious of cases, to connect cognitive dysfunction with MTBI or mild traumatic brain injury.


Studies Are Showing the Connection Between Concussion and Long Term Cognitive Defects

Purdue University researchers studied football palyers at Jefferson High School. Over two seasons they identified 6 concussed players ( those with vissible symptoms) but remarkably 17 players showed brain changes on MRI.

The researchers studied football players for two seasons at Jefferson High School in Lafayette, Ind., where 21 players completed the study the first season and 24 the second season, including 16 repeating players.

"Over the two seasons we had six concussed players, but 17 of the players showed brain changes even though they did not have concussions," says Talavage, an expert in functional neuroimaging and co-director of the Purdue MRI Facility.

They used sensors in the helmets and functional MRI's to show the brain changes. The take away was that the number of hits to the head was significant for brain changes even though no on field concussion had been diagnosed. (2)


Clearly Mild Traumatic Brain Injuries Occur in Car Accidents

There can be little doubt that mild traumatic brain injury can occur from car accidents. The mechanism can be either a blow to the head or the whipping of the head back and forth causing axonal shearing and collison of the brain with the skull.

Researchers have shown the the multifactoral cognitive, personality and emotional changes due to mild traumatic brain injury. There is specific research with regard to car accidents. (3)


Even One Concussion Can Be Enough To Cause Long Term Effects

A recent study was undertaken by lead researcher Yvonne W Lui M.D. , Neuroradiology section chief and radiology professor at NYU Langone School of Medicine. This study is published on line for a fee at the Journal of Radiology.

In a press release Dr Li was quoted " This is the first study to show that the brain undergoes a measurable loss after a concussion. In some patients there were structural changes after a single concussive episode."

What is even more striking about the press release is that it quotes a figure of 10 - 20 % of MTBI patients continue to experience neurological and psychological symptoms more than one year following trauma. Brain atrophy has long been known to occur after moderate and severe head trauma, but less is known about the lasting effects of a single concussion.


Center For Disease Control On Brain Injury

The US Center for Disease Control has some information on brain injury . However this information is rather rudimentary . It is suggested that researching individual studies will aid the practitioner , the injury victims, or the brain injury victim's advocate or lawyer in learning the long term effects of so called "mild traumatic brain injury. "



The challenge to getting help and compensation for brain injury victims is not small. Getting those versed in the most current research, paying for sophisticated testing, and what may be most important , steering clear of biased examiners that are giving there opinions on causal relatioship between a traumatic event such as a car accident injury and the residuals of a concussive brain injury, are important considerations.

As seen in the settlement with the footall players, you can find an expert to testify on any side of the dispute. This has long been known in the personal injury legal profession. Facts and opinions are often blurred. However , the NFL settlement also had many other issues involved such as knowledge and duty by the NFL. So the dollar settlement does not necessarily equate with the lack of proof on repeated head trauma having long term effects. After all the words "punch drunk" is the laymans way of saying too many hots to the head caused brain damage.

It is exceedingly hard for me to see how anyone can dispute the long term effects of repeated blows to the head. Nor should such prejudice exist against the fact of long term sequelae from one blow to the brain.

Citations of authority:



(3) The spectrum of emotional distress and personality changes after minor head injury incurred in a motor vehicle accident

Symptomatic white matter changes in mild Traumatic brain Injury Resemble Pathologic features of early alzheimer 

by Anthony Castelli of the Law Firm of Anthony Castelli Attorney