What is a TBI?

Written by Lee Martyniak, Chartered Legal Executive – Serious Injury Team

At Fletchers Solicitors, we often deal with claims involving Traumatic Brain Injury (TBI).  In this article Lee Martyniak, Chartered Legal Executive in the Serious Injury Team, looks at what a Traumatic Brain Injury is and how they are investigated and classified. 

What is a TBI? 

Often amongst the most serious types of injury, a traumatic brain injury is an injury to the brain as a result of trauma to the head.  There are lots of possible causes, including a fall, road accident or assault. 

These types of injuries can have a massive impact on a person’s life, as well as their family and friends.  Compensation claims for TBI are very complex; they are often high value, and as a result, require lawyers who are experts in their field 

Symptoms of TBI 

What type of symptoms does a person suffer from if they have sustained a TBI?   

Symptoms can be mild, moderate or severe and can appear immediately, but sometimes it can take weeks or months for symptoms to show. The following are all common symptoms of TBI: 

• Confusion 
• Lethargy 
• Vomiting 
• Headache 
• Coma 
• Loss of consciousness 
• Breathing problems 
• Cognitive difficulties 
• Problems with speech 
• Numbness 
• Dizziness 
• Dilated pupils 
• Memory and concentration problems 
• Convulsions and seizures 
• Change in personality

It is sometimes said that a brain injury is like a fingerprint in that each is completely unique to the individual and symptoms can vary greatly from person to person.  Some symptoms may only last a relatively short period of time, others may be lifelong. 

Different types of brain injury 

There is more than one type of brain injury; different parts of the brain are affected depending on the area involved and the nature of the blow.  The following are all common types of brain injury 

• Contusion – a cerebral contusion is the bruising of brain tissue. 
• Haematoma – these can occur anywhere in the brain and are a type of blood clot. 
• Haemorrhage – there are two different types of hemorrhage.  Intracerebral and subarachnoid.  An intracerebral hemorrhage is bleeding within the brain tissue itself.  A subarachnoid hemorrhage is bleeding in the subarachnoid space – over the surface of the brain. 
• Diffuse brain injuries – these are types of brain injury which may not show up on CT scans.  They are more likely to be spread throughout the brain rather than in one specific area. 
• Diffuse axonal injury – this relates to loss of axons and impaired function.  Axons are extensions of nerve cells which allow them to communicate with each other.  If sufficient axons are damaged it can leave a person with severe disabilities as the nerve cells cannot communicate with each other. 
• Ischaemia – this is another type of diffuse brain injury where there is not enough blood supply to areas of the brain.  Correct blood supply is essential to the functioning of the brain.  Disruption to this flow can result in brain injury.  

Altered states of consciousness 

Traumatic brain injuries can often result in a change in consciousness.  These can include: 

Coma – a person is unconscious and unable to respond to any stimuli.  After a period of time a person can awake from the coma or enter a vegetative state. 

Vegetative state – a person is unaware of their surroundings but can open their eyes or make noises.  This may be a permanent state or they may progress to a minimally conscious state. 

Minimally conscious state – the person shows some signs of self-awareness and their environment.  Sometimes there is further improvement. 

Brain death – there is no detectable activity in the brain or the brainstem.  This is irreversible. 

Diagnosing a brain injury 

It is essential to investigate the suspected brain injury as soon as possible following the incident. The following investigations are often carried out: 

• A neurological examination including scoring in accordance with the Glasgow Coma Scale (GCS). 
• A CT scan to look for blood and fractures.
• X-rays. 
• An MRI scan which can detect things which may not have been picked up by CT scan. 

What is the Glasgow Coma Scale? 

The Glasgow Coma Scale is the most common scoring system to measure how conscious a person is based upon three categories and a possible total of 15 marks.  The three categories are: 

1. Eye response – which measures how awake and alert a person is. Max score 4 
2. Motor response – i.e., movement of the body. Max score 5 
3. Verbal response – to show thinking and awareness of surroundings. Max score 6 

Medical staff will assess each category and come up with a total score.  A score of 15 represents a person with normal consciousness. 

Generally, the following ranges tend to be used to classify the level of severity of the injury: 

13-15 Mild TBI 

9-12 Moderate TBI 

3-8 Severe TBI 

The lowest possible score is 3.  The scores can change over time and regular review is essential. 

Post Traumatic Amnesia 

Post Traumatic Amnesia (PTA) is defined as a transient state of confusion, disorientation and memory loss which occurs immediately after a traumatic brain injury. 

The period of post traumatic amnesia and the length of time of being unconscious can indicate the severity of the brain injury.  There may be no continuous memory of day-to-day events and they may be unable to recognise friends and family.  This is a stage that will pass although it can be disturbing for the patient and their family.  This period can vary greatly in length, lasting only a few minutes or up to weeks.   

Compensation claims for Traumatic Brain Injuries 

When making a claim it is essential to choose a firm of solicitors who specialise in brain injury cases.  Fletchers Solicitors are experts at dealing with the most complex cases of traumatic brain injury; we have a number of highly experienced lawyers on hand to offer specialist advice. C all us on 0330 013 0247, or contact us online.   

Information Source: www.headway.org.uk