Diagnosing Concussions And Mild Traumatic Brain Injuries

Health Care Providers Network

One of the troubling medical consequences that we commonly have seen of accident victims who are served by our team at Ashley Gnyś Personal Injury Law Professional Corporation involves concussions.

First of all, what is a concussion?

It is a medical term that refers to a temporary unconsciousness caused by a blow to the head.  Frequently, a concussion is caused by a bump to the head or a sudden direct blow. The word comes from the Latin concutere, which means “to shake violently.” The brain is made of soft tissue, cushioned by spinal fluid, encased protectively by the skull.

When the head is jolted by the application of a traumatic force, the impact can cause the brain to move around in your head. Traumatic brain injuries can cause a variety of injuries involving the nerves, blood vessels and cause bruising. The result can be that your brain doesn’t function normally and becomes confused. Your vision may be disturbed, you may lose equilibrium (balance), or the victim of a concussion may fall unconscious.

Do you remember the cartoon Bugs Bunny?  After he was hit in the head (which seemed to happen often), he often saw stars.

Sometimes when we meet a client who has been concussed, it can be many months after an accident and they have not been diagnosed.  Concussions can be tricky to diagnose in part because you can’t see a concussion.  As is true with many injuries, signs of a concussion may first appear after a considerable time lag of weeks, months or even longer. Some symptoms are transient and only last for seconds while others may linger on for years unless successfully diagnosed and treated.

But how can you be treated for something that has not yet been diagnosed?

At Ashley Gnyś Personal Injury Law Professional Corporation, when we have a new client we look for symptoms being displayed that tell us if our client may be suffering from a post-concussive syndrome (PCS). PCS develops shortly after a concussion and can last for weeks to months, and involves a variety of symptoms that affect your nerves, thinking, and behavior.

Any of these could be a sign of a concussion:

We will have our clients complete a concussion self-test questionnaire that one of our health care professionals uses in her treatment clinic. Experience has taught us that it can take an entire team of health care providers to treat the many facets of a concussed client because several senses can be affected, such as:

  • Hearing loss, tinnitus – audiologist
  • Vision disturbances – neuro optometrist
  • Hormonal deficiencies – endocrinologist
  • Chronic pain – physiatrist
  • Medical testing, blood work – referrals by family physicians

It is key when we open a file for a new personal injury client to take a full medical history.  If we suspect they have suffered a concussion as a result of an accident in the past, we know that to be medically significant as it can lead to the development of a  brain condition associated with repeated blows to the head known as Chronic Traumatic Encephalopathy (CTE).  This condition is associated with the development of dementia. Symptoms involving problems with thinking and memory, personality changes, and behavioral changes including aggression and depression are potential signs of CTE.

We recently settled a motor vehicle accident (MVA) case for $447,500.00 of a victim who was concussed but was never diagnosed with a concussion until several years after the MVA, despite having been seen by a long list of health care providers.  The treatment cost for replacement hormone therapy, drug and vitamin supplements ran thousands of dollars per year and greatly added to the settlement value of the case.  None of that would have emerged had we not suspected our client was suffering from the lingering effects of a concussion.

In 2018 I participated in a continuing education seminar and learned of some of the recent advances being made in the treatment of PCS and so, I became sensitized to the possibility that some of my current clientele may be suffering from undiagnosed concussions. This lead to the referral of our client, who we will call George, to Marianna Varpalotai of Niagara Concussion Management who agreed that indeed George was still suffering from the effects of hitting his head on his car windshield years before.  Visual and other therapy was administered and eventually followed by a referral to Dr. Larry Komer, one of the leading concussion physicians in Ontario. He wrote a book entitled: “New Hope for Concussions, Traumatic Brain Injury, and Post-traumatic Stress Disorder”. It is a must-read for anyone you might know who is suffering from a concussion and who has been told there is no further medical assistance that can be offered.

In summary, what four decades of personal injury law have taught me is that the correct answers to a case start with asking the correct questions and many of those are medical in nature. Understanding the pathology of injuries, physiology and anatomy gives us a leg-up on the entire process and provides us with critical information to better help our clients.

Written by Ashley Gnys, Certified Specialist in Civil Litigation, and Senior Personal Injury Lawyer.  September 4/19