Our Cleveland brain injury lawyers and stroke lawyers approach neurological injury cases with a depth of medical knowledge and years of courtroom experience. Our legal team is committed to helping catastrophic injury victims recover full and fair compensation in these complicated, vigorously defended cases. Let us help and serve you with our reputation and proven results. Contact the Mishkind Kulwicki Law Firm today to schedule a free initial consultation if you or a loved one has questions about someone who has or is suspected to have sustained a traumatic brain injury or stroke as a result of the negligence of another.
Traumatic brain injury (TBI) and stroke are related. The final result, permanent brain damage, is the same, but the mechanism of injury is different. Traumatic brain injury results from trauma caused by a force outside of the body, such as a car accident, a fall, an assault, knockdown of a pedestrian or bicyclist, explosion, electrical shock, defective product, workplace injury and any other event that results in a concussion. This type of injury is often referred to as post-concussion syndrome or chronic traumatic encephalopathy (CTE), as well as TBI. Depending on the nature and extent of the injury, TBI can affect intellectual, cognitive and emotional function, but severe TBI may also result in motor and sensory deficits, like paralysis, paraplegia or quadriplegia. Other physical manifestations of TBI include headache, dizziness, hearing loss, tinnitus (ringing of the ears), visual disturbances, and changes in hand-eye coordination. Along with traumatic brain damage, damage can occur to the pituitary gland which functions as the “nerve center” of the body’s endocrine system. Pituitary imbalances can lead to various hormonal imbalances, including low testosterone.
The term “stroke” refers to brain damage that results as a result of occurrences occurring wholly within the body. Ischemic stroke occurs as a result of blood clots in the body, called emboli, traveling through the circulatory system to arteries within the brain where they cause an obstruction. Obstruction or occlusion by an embolism stops the flow of blood and oxygen to the brain. When there is a cessation of blood and oxygen to brain cells, they gradually die off. Unlike other organs within the body, brain cells do not regenerate once they have died off. Blood clots can form for a number of reasons, but most commonly due to narrowing of the carotid arteries that provide much of the blood flow to the brain or a cardioembolic source. Cardioembolic sources include atrial fibrillation which results in ineffective pumping of the heart and the buildup of clots which, once formed, are spontaneously expelled into the circulatory system where they travel to the brain.
Another type of stroke is a hemorrhagic stroke, or brain bleed. Hemorrhagic strokes can occur for a number of reasons, including a ruptured aneurysm or a clotting disorder in conjunction with minor trauma.
A growing source of stroke, especially among young people, is related to trauma to the arteries supplying the brain due to horse collaring that may occur during horseplay or sports like football. The resulting carotid dissection or vertebral dissection can obstruct blood flow to the brain.
Many strokes are localized to one hemisphere (half) of the brain. When this occurs, the injury manifests as loss of motor or sensory function in one side of the body. Other strokes have a global impact, resulting in damage to both hemispheres of the brain, which can manifest as neurological dysfunction affecting the entire body. Any stroke can result in intellectual, cognitive and emotional abnormalities, along with the physical manifestations.
One type of global insult that can lead to a stroke affecting both hemispheres of the brain occurs as a result of hypotension, or abnormally low blood pressure, that can occur when an individual goes into shock. Shock occurs when the heart can no longer supply adequate blood flow to perfuse end organs, such as the kidneys, liver, lungs, heart and brain. Shock can occur for a number of reasons, including blood loss (hemorrhagic shock), severe infection (septic shock) and heart attack (cardiogenic shock).
A skilled traumatic brain injury lawyer or stroke lawyer will want to obtain all medical records that document the injury in order to understand how the stroke occurred. Imaging, such as CT scans and MRI results, are crucial to understanding the mechanism of how a stroke occurred. The scans will reveal areas of damage, called infarction, which reveal which blood vessels in the brain were affected. A detailed neurologic assessment by an emergency room physician, neurologist or neurosurgeon provides additional information about the nature of the injury.
Personal injury lawsuits arising out of TBI or stroke are unique in a number of ways. First, the anatomy of the brain and brain damage is extremely complex. Your lawyer must be familiar with the various mechanisms of brain damage, treatments, and disabilities associated with permanent brain damage. Second, the harm associated with brain damage is “hidden,” in the sense that intellectual, cognitive and emotional disabilities are not readily visible or readily tested or easily proven. Finally, the legal damages associated with permanent brain damage can be extensive and require various expensive experts to prove them at trial. So, your traumatic brain injury lawyer or stroke lawyer must have the resources to fund expensive stroke or TBI litigation.
Because evidence of brain damage may be “hidden,” we interview friends and family members to ask about symptoms and also to get a before and after picture. Following are some relevant questions:
- What was your relationship with (client)?
- How long have you known him/her?
- What kind of things did you do together, shared experiences, etc.?
- How often did you see each other, talk, etc.?
- How has that changed since the injury?
- What do you miss most about how things used to be?
- How has the injury affected your relationship with him/her?
- How has the injury affected 9client’s) relationship with others?
- What are the most important things you still have together?
In Ohio, damages that are recoverable in a personal injury lawsuit are broken down into economic and noneconomic damages. Noneconomic damages include those harms that don’t come with a tangible price tag, such as pain, suffering, loss of usual activities, emotional distress and loss of enjoyment of life. These damages are subject to caps under Ohio law. The caps vary depending upon whether the case is a personal injury or medical malpractice case and the nature and extent of disability caused by the injury. There are no caps on wrongful death claims in Ohio.
Economic losses, by contrast, are not capped. Economic losses include loss of income, loss of benefits, loss of future earning capacity, loss of household services, past and future medical costs and costs of daily living associated with disability. Because noneconomic losses are capped, it is imperative to fully capture all of the economic losses associated with a stroke or brain injury lawsuit in order to obtain full compensation for the injury victim.
To estimate future wage loss caused by a traumatic brain injury or stroke, a personal injury lawyer will look at your past history of earnings and the nature and extent of your disability. When an injury victim can no longer work, the determination of future loss of wages and benefits is somewhat straightforward. However, in many instances, the picture is clouded by other factors, such as preexisting disability, failure to report all taxable income (“working under the table”), reduced income associated with start-up of a new business, erratic earnings or the ability to carry a reduced workload after the injury. In these circumstances, it may be necessary to hire a forensic economist or vocational rehabilitation expert to determine the full extent of lost future earnings.
Future medical costs and costs of living associated with a disability pose another challenge. In some instances, the disability associated with a TBI or stroke is impactful enough that the injury victim must have around-the-clock care at home or in the setting of a skilled nursing facility. Sometimes, care needs are not as extensive, and the injury victim’s needs can be met by occasional homecare, either by a registered nurse or a trained attendant. In addition, consideration must be given to the costs of accommodations needed to meet the challenges of disability, such as transportation, ramps, a disability-friendly bathroom and kitchen, etc. These extra costs of living, called life care expenses, and future medical costs, can be estimated by a certified life care planner.
We work with a variety of trial experts on a routine basis in an effort to fully account for all of the damages caused by an avoidable or preventable brain injury or stroke. If you have questions about a case involving brain injury or stroke, we can help you. Howard Mishkind and David Kulwicki, with a combined 60-plus years of courtroom experience, have tried over 100 jury trials and have recovered over $300,000,000.00 in verdicts and settlements on behalf of our deserving clients. We have extensive experience with brain injury, stroke and other neurologic injuries, such as paralysis, paraplegia and quadriplegia. We want to help you with your legal problem.