Living With a Traumatic Brain Injury?

What Is a Traumatic Brain Injury?

A traumatic brain injury (TBI) is an injury that affects how the brain works, and the resulting changes may affect how a person thinks, learns, feels, acts, and sleeps. A TBI does not require a blow to the head: the brain can also be injured by acceleration and deceleration forces without direct contact to the head, the forces a sudden stop in a vehicle produces. The traumatic brain injury attorneys at Sam Aguiar Injury Lawyers represent Kentucky accident victims whose symptoms continue after the first hospital visit.

Most TBIs are mild TBIs or concussions, and the effects of a mild TBI or concussion can still be serious. The United States recorded approximately 214,110 TBI-related hospitalizations in 2020 and 68,663 TBI-related deaths in 2023.

Traumatic Brain Injury Severity Levels

Emergency teams score a brain injury on the Glasgow Coma Scale (GCS), which rates eye-opening, verbal, and motor responses for a total from 3 to 15. A score of 13 to 15 is mild, 9 to 12 is moderate, and 3 to 8 is severe. The GCS is useful for triage, but it remains a poor predictor of long-term functional outcomes, and sedatives may depress the score.

A mild classification does not describe a minor injury. In a Glasgow cohort of hospitalized adults with TBI of all severities, 53% of survivors were disabled at 5 to 7 years. The American Congress of Rehabilitation Medicine’s 2023 criteria for mild TBI set a ceiling of 30 minutes of lost consciousness, a GCS score of at least 13, and post-traumatic amnesia under 24 hours.

Neuroimaging is not necessary for a mild TBI diagnosis, which can rest on clinical signs, or on acute symptoms with a clinical finding.

Vehicle Accident Brain Injury Mechanisms

Motor vehicle crashes caused 23.8% of nonfatal TBI-related hospitalizations in 2018, second to unintentional falls at 51.0%. Estimates from 1997 to 2007 data put annual motor vehicle crash TBIs at 218,936 emergency department visits, 56,864 hospitalizations, and 16,402 deaths.

Direct Impact

The head strikes the steering wheel, a window, a door frame, or a headrest. CT is the first image ordered because it is fast and accurate at detecting injuries that need neurosurgical intervention.

Coup-Contrecoup Injury

The brain is bruised at the point of impact (coup) and on the opposite side as it rebounds inside the skull (contrecoup). The head does not have to hit anything for this to happen, and a normal CT scan does not rule out a coup-contrecoup injury.

Rotational Shear Injury

Rapid rotational or translational head movements place shear strain on white-matter tracts, an injury called diffuse axonal injury (DAI). Angular or rotational acceleration is the most efficient mechanism to cause it, and road traffic collisions account for the majority of DAI across all age groups.

Whiplash Movement

A hit to the body can make the head and brain move quickly back and forth, which injures the brain without a blow to the head. A traumatic brain injury can happen even in a moderate-speed accident.

Penetrating Injury

Glass or debris that enters the skull is a penetrating injury. CT needs no safety screening, an advantage with penetrating injuries.

Diagnostic Testing After a Brain Injury

CT is the mainstay of imaging for acute TBI, and it has limited sensitivity for nonhemorrhagic and small axonal lesions. MRI is more sensitive for axonal injuries and blood products 24 to 48 hours after injury, and it is indicated when CT is normal and unexplained neurologic findings persist. A normal CT scan does not rule out a brain injury.

For diffuse axonal injury, susceptibility-weighted imaging is considered the most sensitive method for small hemorrhagic foci, and diffusion-weighted imaging identifies early cytotoxic edema. Diffusion tensor imaging (DTI) is sensitive to microstructural axonal injury, but it remains investigational for assessing TBI in individual patients, because the same changes appear with other conditions.

Neuropsychological evaluation helps clinicians assess a patient’s condition, reach differential diagnoses, and plan treatment. It measures attention, executive function, memory, reasoning, and problem-solving, the areas where a TBI produces deficits.

Dizziness, balance problems, and vision problems are among the physical symptoms listed for TBI, and the 2023 criteria count balance impairment and oculomotor impairment on clinical examination as findings that support a mild TBI diagnosis. Clinicians grade TBI severity with the Glasgow Coma Scale, and a score of 13 to 15 is mild, 9 to 12 is moderate, and 3 to 8 is severe.

Traumatic Brain Injury Symptoms

Symptoms fall into four groups: physical (headaches, dizziness or balance problems, light and noise sensitivity, vision problems), thinking and remembering (attention and concentration problems, memory problems, feeling slowed down), social or emotional (irritability, anxiety, sadness), and sleep (sleeping less or more than usual, trouble falling asleep).

Symptoms may take hours or days to appear or be noticed. A dated symptom log shows a treating doctor the pattern and shows when each change began. 53% of adults with a mild traumatic brain injury reported some functional limitation 12 months later, compared with 38% of people with orthopedic injuries.

Long-Term Effects of Traumatic Brain Injury

TBI keeps evolving after the acute period and is a chronic health condition with lifelong effects. An estimated 1.1% of the US population has lifelong disabilities from TBI treated in hospital. Documented outcomes include:

• Dementia: in adults 55 and older, TBI was associated with a 26% higher adjusted hazard of a dementia diagnosis, and mild TBI with a 25% higher hazard in those 65 and older
• Stroke: an adjusted hazard ratio of 2.32 at five years after TBI
• Seizures and drug poisoning: people who survive a moderate or severe TBI are 50 times more likely to die from seizures and 11 times more likely to die from drug poisoning
• Disability and work: five years after a moderate or severe TBI, 57% are moderately or severely disabled, 55% of those employed before the injury are not working, and 33% rely on others for everyday activities
• Life expectancy: after inpatient rehabilitation for a moderate or severe TBI, life expectancy is 9 years shorter
• Behavior: apathy, irritability, aggression, disinhibition, and mood disorders

Treatment Records

Every visit to a primary care doctor, neurologist, or physical therapist for brain injury symptoms adds to the medical record that supports the case. A gap in treatment, even one caused by a missing ride, childcare conflicts, or insurance confusion, gives an adjuster room to argue the injury resolved or was never serious. Consistent follow-up, with symptoms documented at each visit, keeps that gap from opening.

Referrals build the same record. A primary care visit that leads to a neurology referral, which leads to neuropsychological testing, creates a documented progression that mirrors how a brain injury is diagnosed and treated. Each referral recorded in the chart with its date and reason gives an adjuster or a jury a clear path from the accident to the diagnosis.

Hospital records start the case file on the first day. In a survey of 66 clinicians who care for TBI patients in the ICU, 98% recommended rehabilitative care during the ICU stay, so therapy notes from the hospital stay belong in the record alongside outpatient visits. The hospital’s trauma designation affects which specialists treat a severe brain injury, and Kentucky trauma center levels identify hospitals’ resources for treating serious injuries and arranging transfers.

Daily Life Evidence

A person with a mild or moderate TBI can look and sound fine to friends, family, and insurance companies while memory problems, emotional changes, and cognitive gaps make work and relationships hard. Documentation is the central task in a Kentucky TBI case.

Statements from coworkers, supervisors, and family members describe concrete changes: missed deadlines that never used to happen, a person who ran the household finances now struggling to balance a checkbook, a parent who forgets to pick up a child from practice for the first time in years.

A wage statement showing a drop in overtime hours, a written warning tied to missed deadlines, or a formal request for workplace accommodations points to the same conclusion from outside the medical chart. Return-to-work timelines are rarely linear: a person may attempt a return, struggle through reduced hours, and step back again.

At home, a parent who managed the household schedule may need reminders for routine tasks, and a spouse may take over responsibilities the injured person handled for years. These shifts belong in the case file because they show the lived cost of the injury alongside its clinical description.

A child with a brain injury may not be able to describe memory problems, headaches, or mood changes. Parents and teachers can notice the change first: a drop in grades, a shorter attention span, new irritability, or sudden reluctance to do homework that used to come easily. A pediatrician or pediatric neurologist familiar with post-accident evaluation can tell a cognitive change from ordinary childhood behavior.

Recoverable Damages Under Kentucky Law

TBI survivors in Kentucky accident cases can pursue:

• Medical expenses, past and future, including rehabilitation, medications, and long-term care
• Lost wages and diminished earning capacity when the injury prevents a return to the same occupation at the same level
• Pain and suffering, including physical pain, mental anguish, and loss of enjoyment of life
• Loss of consortium for the injury’s impact on the relationship with a spouse and family

Life care planning projects future costs. A certified life care planner totals ongoing rehabilitation, medication, home modifications, and attendant care, and that projection supports the economic damages. Umbrella and excess liability policies add coverage on top of a driver’s regular auto insurance, and an umbrella starts paying after the at-fault driver’s auto liability limit is used up.

When a brain injury results in death, Kentucky’s wrongful death statute provides an action that the personal representative of the deceased prosecutes. Damages may be recovered from the person who caused the death or whose agent or servant caused it.

Sam Aguiar Injury Lawyers for Brain Injury Cases

A brain injury case rests on records that show the change: the diagnostic criteria for mild TBI, consistent treatment notes, neuropsychological testing, imaging, and statements from the people who see the injured person every day. Where a diagnosis is disputed, independent neurologists and neuropsychologists can address the injury’s cause, severity, and expected course.

Bigger Share Guarantee®: clients always walk away with more money than the firm after medical bills, liens, and case expenses are paid. If the client’s share would ever be less than the legal fee, the firm cuts its fee.

• Dedicated three-person team: a top-rated attorney, an experienced case manager, and a skilled legal assistant.
• Flat contingency fee that never increases if your case goes to trial.
• $0 Out-Of-Pocket Forever.

Keep every scan, test result, and therapy note. You focus on getting better. We handle everything else. Some of the changes a brain injury causes show up days or weeks after the accident. If symptoms continue after an accident, request a free case review.