The increase in mild brain injuries

Claims involving mild head trauma appear to be on the rise.

Earlier this year (April 25, 2023), The Times published an article commenting on a recent study showing that some people who suffered even mild “hits” to the head could have suffered a brain injury, causing long-term problems for those people. people. people. This often resulted in a claim for compensation where the harm was caused due to a preventable accident.

These minor head injuries can often be caused by a variety of activities, from simple falls at home, playing rugby, being involved in road accidents or simple DIY projects gone wrong.

The Times highlighted a University of Cambridge study, published by lead author Dr. Emmanuel Stamatakis, in the August 2023 issue of the journal “Brain” and on the University of Cambridge website on April 26, 2023, which indicates that about 47% of people in a study A group of 108 patients with mild blows to the head often suffered symptoms for more than 6 months, including depression, fatigue and headaches . In some cases, victims of such a blow or injury did not even receive treatment in hospital or at their local GP. Such cases, according to the study, can be classified as mild traumatic brain injury (“mild TBI”) and can often go undiagnosed, or not detected until months or even years later, which of course poses problems for people who have suffered such damage and the insurers who are responsible for compensating these people.

The study, titled “Acute thalamic connectivity precedes chronic post-concussion symptoms in mild traumatic brain injury. said that:

We compared resting structural MRI and functional MRI in 108 patients with Glasgow Coma Scale (GCS) 13 to 15 and normal CT scan, and 76 controls. We examined whether acute changes in thalamic functional connectivity were early markers of persistent symptoms and explored the neurochemical associations of our findings using PET data. mTBI (mild head trauma) cohort, 47% showed incomplete recovery 6 months after injury. Despite the absence of structural changes, we found acute thalamic hyperconnectivity in mTBI, with specific vulnerabilities of individual thalamic nuclei.

They concluded that the hope was that studying early “thalamic pathophysiology” (essentially noting an abundance of activity in the thalamus region of the brain to overcompensate for any potential damage) could help identify cases where chronic symptoms are likely to occur in people suffering from a chronic illness. Mild TBI and that new therapies and medicinal applications could be developed to help combat these symptoms.

What about the long-term effects on mortality of mild head trauma?

A study from the Department of Neurology at the University of Pennsylvania Hospital titled “Head injuries and long-term mortality risk among community-dwelling adults”by Holly Elser et al, was published in January 2023. The aim of the study was to examine the long-term effects on mortality of even minor head injuries.

Of the sample of 13,037 participants over a period of 30 years from a median age of 54 years, only 18.4% had suffered a head injury (2,042 people) and the vast majority of this percentage having suffered a head trauma (approximately 95%) were classified as having “mild head trauma”.

The study concluded that the vast majority of those who suffered some form of head trauma had reduced mortality compared to the control group, with an increased “hazard ratio” of 1.99. Simply put, their lifespan was noticeably shorter, even with a minor injury.

Causality, post-concussion syndrome and functional neurological disorder

Of course, issues of causality will always arise when attempting to identify potential brain injury. Usual indicators of a brain injury usually involve a review of a patient’s ambulance records, which may include a reference to a falling Glasgow Coma Scale score of 15, or perhaps a mention of a loss of consciousness, or post-traumatic amnesia, or even a bump or bruise to the head.

The Mayo head injury classification system states that mild head injury may occur if there is one or more of the following:

  1. Loss of consciousness;
  2. Post-traumatic amnesia; Or
  3. Skull fracture.

In the absence of any of these symptoms, then one or more symptoms of blurred vision, confusion, dizziness, seizures, headache or nausea could, according to the Mayo system, indicate a possible cerebral lesion – brain-damage.

There is of course also the potential diagnosis of functional neurological disorder (FND), which can often arise when there are no traditional diagnostic indicators of a sustained brain injury and yet the person still has cognitive problems. A common indicator of a “functional” component of an injury can be seen when symptoms worsen over time, which will not occur when an organic injury has been sustained and/or identified.

Therefore, in light of the above, it is increasingly possible for a plaintiff to plead brain injury.

What does this mean for insurers and how can they identify potential head trauma?

It is important for insurers to identify at an early stage any claims which may refer to a blow/blow to the head, or indeed any reference to cuts or abrasions to the head or face following an accident. An early request to secure the injured person’s medical records (especially ambulance records) can greatly help identify such cases.

Early detection of these issues will allow indemnifiers to respond and position themselves accordingly – and take a collaborative approach with claimants and their representatives to thoroughly investigate such an incident. When in doubt, early referral to in-house technical teams and experienced head injury attorneys for a second opinion can often prove invaluable.

The hope is, as the Cambridge University study mentions, that early treatments can be developed to better help those who have suffered a brain injury, however mild.

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