The journal Brain is reporting that brain injury is a progressive condition that worsens over time. This is a significant finding for victims of traumatic brain injury (TBI). Prior to this study, it was felt that brain injuries worsen with time based on anecdotal evidence, but no study existed that allowed physicians to opine that an individual’s cognitive disability would deteriorate as the individual aged. This study will have an impact on every TBI lawsuit.
The Brain study found that chronic traumatic encephalopathy (CTE) — the brain disorder that has been tied to depression and suicide in professional athletes — has an “ordered and predictable progression.” The researchers arrived at this finding by studying the brains of military personnel and athletes who had been subject to repeated head injury.
The researchers identified a four-stage progression as follows:
- Stage I: headache, loss of attention and loss of concentration.
- Stage II: depression, agitation and short-term memory loss.
- Stage III: executive dysfunction and cognitive impairment.
- Stage IV: dementia, difficulty finding words (aphasia), aggression, paranoia, depression, impulsivity and visuospatial abnormalities.
Each of these stages was accompanied by changes in the brain that correlated with the foregoing symptom complexes.
Interestingly, there was no correlation between the number or severity of concussions and the severity and progressivity of the disease process. This means that even a minor concussion can have profound long-term consequences.
For lawyers who handle brain injury cases, this study is not surprising. Those of us who monitor medical literature that pertains to brain injury, encephalopathy and post-concussion syndrome, have long suspected that this disease process worsens with time, particularly as a patient ages and overall cognitive function declines. But this study describes a specific mechanism and pattern of progression that was previously unstudied.
For brain injury lawyers, this study has pertinent implications. Not only must we look at the client’s current condition, and evaluate the costs of care in that context, but we must also evaluate care costs that will likely arise in the future. This will include advanced therapy, institutional care and other life care plan costs.