Severe traumatic brain injury (TBI) is less common than milder forms of the injury, so it gets less attention in the medical literature and in the courtroom.  Because the physical signs of severe TBI are more concrete and more objective, it is more difficult for insurance companies and defense lawyers to attribute the symptoms of severe TBI to malingering and exaggeration, as they routinely do in mild TBI cases.  However, the long term effects of this injury must be well understood by personal injury lawyers in order to obtain full and fair compensation on behalf of their injured clients.

Mild TBI is written about and litigated with much greater frequency due to the gray areas associated with proving the existence of this injury.  However, after reading recently updated medical guidelines for the treatment of severe TBI, I thought it was worthwhile to blog about severe TBI.  The guidelines, titled “Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition,” were recently reported in the journal Neurosurgery.  Sadly, these guidelines underscore the debilitating nature of this type of injury and the fact that once brain tissue is destroyed, it cannot be recovered.

Severe Traumatic Brain Injury Guidelines

The main thrust of the new guidelines has to do with interventions designed to relieve intracranial pressure caused by brain swelling after trauma.  These interventions include decompressive craniotomy (i.e., removal of a portion of the skull) and use of a shunt to drain fluid from the brain.  There are no guidelines that address optimal rehabilitation programs, the use of neurontin or antidepressants, or counseling of and support for family members.

The result of severe TBI is a lifetime of motor, sensory, cognitive and behavioral deficits and dysfunction.  The impact on family members is equally devastating as they adjust to a loved one who simply is not all there.  Worse yet, studies show that individuals who suffer brain damage are more susceptible to dementia as they age.  It stands to reason; as the brain ages and deteriorates naturally, the brain injured person has less brain tissue to manage executive functions.

Ohio brain injury attorneys who handle severe brain injury cases resulting from an automobile or truck crash, an explosion, a work accident, an electrocution and other acts of negligence must be well-versed in all aspects of the injury, the law governing liability, and how to calculate all economic losses suffered by the brain injured client, including lost wages and benefits and the costs of future care.  Additionally, to fully protect the brain injured client, the attorney must understand the interplay between the civil action and other sources of recovery such as Workers Compensation, Medicare, Medicaid and private health insurance.  Finally, in order to preserve any funds recovered on the brain injured client’s behalf, the injury lawyers must understand those probate and financial planning tools that are available.

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