Source: Definition of Mild Traumatic Brain Injury Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine.
J Head Trauma Rehabil 1993:8(3):86-87
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In most cases of TBI without coma, the emergency room records will say "no reported loss of consciousness." But how do we know there wasn't? The emergency room personnel are never at the scene, and there usually is at least a half hour gap between the time of the accident and the patient's arrival at the hospital. Who was there during the critical moment to tell?
If the only person who is asked whether there was a LOC is the patient, then the report in the emergency room record that there was no LOC, is of little significance. The injured person is a particularly poor historian of events for something that occurred when they may have been unconscious, disoriented or suffering from amnesia.
A Second Look at the Medical Records.
While you don't rely on the medical records, you don't ignore them either. The clues are often there, especially in the ambulance records. Is there a reference to disorientation, nausea, or the need for oxygen in ambulance records? Is what the patient said to the ambulance attendants with respect to symptoms and the events of the accident, consistent with what the patient told the ambulance attendants?
The Lawyer's Role.
By way of the lawyer's training and expertise in interrogation, the lawyer can often get a better sense of whether there was an LOC. Do a detailed questionnaire with respect to accident facts. Very carefully, walk the client through the accident details. Go back over the details several times, each time telescoping the time sequenced, getting more and more precise as to exactly what is happening just before impact, and just after the vehicles come to a rest. Watch for "the next thing I remember." Can the client give you a complete history, or are there jumps? What did the crash sound like? It is significant if the injured person cannot remember something as loud as the sound of the crash? In a surprising number of cases, there will be a gap in memory, if not consciousness.
Next: Emergency Room Misdiagnosis
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subtlebraininjury.com is a website with a mission to educate with respect to the magnitude of brain injury which does not involve coma - injuries that have been labeled by names which grossly minimize their potential impact upon the life of the injured person. This site is brought to you by the advocates of the Brain Injury Law Group, a community of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI.
Additional Information
For a full treatment of the topic of brain injury, and recovering adequate compensation for those who have survived such injury, please visit our other pages. tbilaw.com A general treatment of all types of brain injury, including severe brain injury and concussion, with a special focus on the legal aspects of recovering full and adequate compensation for such injuries. tbilaw.com has been at the cornerstone of the web advocacy of the Brain Injury Law Group since it went online in 1996. waiting.com A page designed to assist those with issues regarding coma, especially in the acute phase when the doctors are saying "I just don't know." vestibulardisorder.com Addressing vertigo and dizziness resulting from trauma as well as information and resources for vestibular disorders.
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