Motorcycle Accident Brain Injuries
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Motorcycle Accident Brain Injuries
Not only is motorcycle accident brain injury one of the most common injuries suffered in motorcycle accidents, but it is also the leading cause of fatalities in bike crashes in California. Brain injuries are also one of the most serious and most costly injury types in non-fatal motorcycle accidents. In fact, brain injuries are so common in automobile crashes that stats show these types of accident account for 28% of all brain injuries nationwide. And, unfortunately, motorcyclists are more likely to suffer brain injury than an automobile operator, even if they are wearing a helmet.
While many of us picture severe head wounds when we hear the term Traumatic Brain Injury, this category of injury includes multiple types of brain trauma including minor concussions. It's important to understand that Traumatic Brain Injury (or TBI) is a wide-ranging term that encompasses multiple types of injury, multiple levels of severity, and multiple treatment options.
What is Traumatic Brain Injury or TBI?
Technically speaking, TBI is simply any sort of traumatic injury that affects the brain. This can include anything from a mild concussion to a penetrative injury that opens the skull. There are two major types of TBI:
- Closed-head injuries—in which the skin and/or skull are intact but injuries to the brain and surrounding soft tissue cause potentially life-threatening effects.
- Open-head injuries—in which the skin or skull either breaks open or is penetrated by a foreign object.
Closed-head injuries are the most common. But, just because the skin isn't broken doesn't mean that victims aren't in danger. In fact, closed-head brain injuries include concussion, contusion, and internal bleeding that can cause severe damage to the delicate brain and nerve tissue in the skull. This damage can result in long-term disabilities and even death in severe cases.
Judging the Severity of TBI
Judging the severity of TBI is almost impossible upon primary physical inspection. That's why doctors in ER situations often order additional testing for individuals involved in motorcycle accidents. These experts than combine the results of multiple tests and observations in order to estimate the severity of an individual victim's brain injury. However, even then the diagnosis is only an estimate. Patients who have suffered motorcycle accident brain injuries must be closely monitored in the days and weeks following their crash in order to spot the onset and reduce the risk of secondary brain injury.
TBI Severity Ratings
Mild TBI — eyes open, victim is awake and responsive
In these cases, the majority of victims suffer temporary symptoms like confusion, disorientation, or a headache and may or may not lose consciousness for brief amounts of time. Mild TBI often heals itself though some research suggests that even mild Traumatic Brain Injuries increase the risk of severe side effects and even death in future TBI incidents.
Moderate TBI — eyes open, but victim is lethargic and slow to respond.
In these cases the victim will likely lose consciousness for an extended period of time (up to 6 hours) and may experience:
- Brain swelling
- Nerve damage
Severe TBI — Unconscious and unresponsive.
These cases are associated with losses of consciousness of 6 hours or longer and usually result in long-term damage. In some cases coma (extended periods of unconsciousness) may last for days, weeks, month, or forever.
Five Types of TBI
TBI is really a catchall term and it's important to understand that there are 5 major types of Traumatic Brain Injury.
- Diffuse Axonal Injury (DAI)
- Traumatic Subarachnoid Hemorrhage (tSAH)
Concussions occur when the brain actually "sloshes" around inside the skull. It may or may not "bang" off the interior of the skull and often involves two actual impacts—the primary impact as the head jerks in one direction, then the secondary impact as it rebounds in the opposite direction. Concussions can occur with or without external impact meaning victims can even suffer from concussions in "whiplash-style" accidents.
Victims suffering from concussions may experience headaches, dizziness, vomiting, or lethargy but unless the injury is severe, the most common treatment for concussion is management of pain while the soft tissue of the brain heals itself.
While concussions are generally regarded as the mildest form of TBI, they can lead to serious long-term conditions if they occur repeatedly. In fact, emerging research shows that victims who experience multiple concussions over a lifetime are more likely to develop serious neurological disorders like Parkinson's Disease.
Contusions are essentially bruises on the brain. The force of an impact caused by a motorcycle accident brain injury can often break blood vessels in or on the brain leading to bleeding. Many times these contusions are minor and will heal over time. However, sometimes when a contusion is severe it can dramatically increase the pressure inside the skull. This pressure is dangers and can lead to secondary brain injury. Sometimes surgical procedures are performed to remove the contusion or relieve the pressure on the brain. Contusions should not be confused with Hematomas. Hematomas are actually blood clots in or on the brain.
3. Diffuse Axonal Injury
DAI (as it's often called) occurs when the G-Forces exerted on the brain during a motorcycle accident actually stretch the tissue of the brain itself. This can increase the distance between axons (brain cells) and decrease or eliminate the ability of the neurons in the brain to communicate.
Diffuse Axonal Injury can lead to cognitive issues, speech disability, memory issues, and more.
In many cases, the axon will either repair themselves or the brain will actually reroute essential nervous traffic. However, in severe cases, DAI can result in Persistent Vegetative States or even death.
4. Traumatic Subarachnoid Hemorrhage
This type of motorcycle accident brain injury occurs when blood leaks into the void in the skull typically filled with cerebral fluid. This can cause severe life-threatening conditions and may result in permanent brain damage or death. Indeed, this type of bleeding can lead to stroke, seizures, and brain death.
Unfortunately, treatment options for Traumatic Subarachnoid Hemorrhage are limited and 25%-78% of victims will either not survive treatment or will survive but only in a vegetative state. In addition, 12% of survivors suffer life-long disability.
A hematoma is essentially a blood clot. These blood clots are caused by blood vessels broken by the initial trauma of a TBI. These clots can remain the same size or they can grow. The main danger from this type of motorcycle accident brain injury is the increased pressure inside the skull.
While some hematoma patients survive without surgical intervention, many victims must undergo some sort of procedure to relieve the pressure inside the skull up to and including complete physical removal of the hematoma.
Symptoms of TBI
Many of the symptoms of these multiple types of TBI are the same and may include:
- Loss of consciousness
- Memory loss
- Fatigue or lethargy
- Visual disturbances
- Inability to concentration
- Disruption of normal sleep patterns
- Irritability and emotional outbursts
It's important that any victims involved in a motorcycle accident seek immediate medical attention if they're experiencing any of these symptoms either immediately after or in the days following their accident. TBI can lead to secondary brain injury if the initial trauma isn't diagnosed and treated immediately.
Secondary Brain Injury
TBI is considered a primary brain injury and results directly from the blunt or sharp force trauma exerted on the skull during a motorcycle accident. The brain injuries suffered in these types of accidents are caused either by:
- The brain "sloshing" against the skull
- Penetrative objects traveling through the skull into the brain
- Stretching and tearing of the brain tissues due to G-Force shock
Secondary brain injuries can occur minutes, days, or even weeks after the initial trauma and are caused by internal bleeding, swelling, and pressure on the brain. This increased pressure can lead to:
- Decreased blood flow
- Impingement upon critical nerve tissue
- Tissue damage or death
These types of injuries are often categorized as silent killers because individuals who have suffered TBI may not even realize they are undergoing secondary trauma. Many people don't notice any symptoms or if they do the symptoms they report or limited to:
- Lethargy or sleepiness
How is TBI Diagnosed?
When a motorcycle accident victim is admitted to the ER, doctors will assess the injured individual using a variety of tests to determine the likelihood of Traumatic Brain Injury. The first is a multi-stage test that involves a physical exam combined with cognitive testing.
Glasgow Coma Score
One of the first steps is using the Glasgow Coma Score (GCS). This 15-point scale grades a patient's level of consciousness through observation of muscle, eye, and cognitive response. Each individual assessment is given a score and the total is used to determine the level of potential injury.
(A score of 13-15 is considered mild, a score of 9-12 is considered moderate, a score of 8 or below is considered severe.)
If doctors suspect that an individual is suffering from TBI, they will initially stabilize life-threatening injuries to the body then order medical imaging on the brain.
Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans can be used to see what is going on inside a victim's skull. Doctors will look for dark spots, deformities, and other abnormalities to assess which portions of the brain are injured and how severe those injuries may be.
Treatment for TBI
Mild cases of TBI can be treated with pain relievers while the body heals itself. More advanced cases may require surgical intervention, drug therapy, or even medically induced coma to treat.
Doctors will monitor:
- Intracranial pressure (pressure inside the skull)
- Brain oxygen levels
- Seizures (via Electroencephalogram—EEG)
The short-term goal of any treatment for TBI is to resuscitate and support the victim while minimizing the risk and effect of secondary brain injury. Successful medical treatment for TBI results in the patient transferring to the recovery phase but healing the physical injury is just the first step toward total recovery.
Surgical Procedures Associated with TBI
While many individuals who suffer motorcycle accident brain injuries may not require surgical intervention, sometimes "going under the knife" is the only way to save a patient's life and prevent long-term brain damage. Typically procedures associated with the treatment of TBI include Craniotomy and Craniectomy.
During a craniotomy, surgeons remove a portion of the skull to gain access to the brain. Typically this procedure is performed when a contusion or hematoma is increasing the pressure inside the skull to dangerous levels. Once the underlying issue is corrected, the bone is replaced and the surgical wound is closed.
During a craniectomy, a large portion of the skull is actually removed to allow the brain to swell without impinging on the blood flow and nerve functioning. Special protective tissue is placed upon the brain and the wound is closed. Typically, 1 to 3 months later the bone fragment is replaced in a secondary surgical procedure called a cranioplasty.
The Long-Term Effects of Motorcycle Accident Brain Injuries
In addition to the immediate medical needs of victims of bike crashes, there is an extensive list of potential long-term effects of motorcycle accident brain injuries. While not all victims will suffer all of these symptoms, it's likely that most will suffer at least one or more of these "side effects" to some degree. These detrimental effects include:
- Loss of gross or fine motor skills
- Paralysis (partial or complete, temporary or permanent)
- Memory loss
- Speech Disabilities
- Cognitive disabilities
- Personality Changes
- Inability to control moods
- Depression and other diagnosable mental disorders
- Decreased income (or the inability to maintain steady job)
Because of the complicated nature of brain injuries, many non-medical approaches are used in order to get victims as close to their old "normal" as possible. These include:
- Physical Therapy
- Speech Therapy
- Occupational Therapy
- Counseling Services
These non-medical procedures are used to help victims of traumatic motorcycle accident brain injury regain abilities they've lost through retraining of the muscles and mental faculties that were damaged during the initial injury or from secondary brain injuries caused by the TBI.
While such therapies enjoy a tremendous success rate, it's important to note that a significant percentage of victims who survive TBI caused by motorcycle accidents will have some long-lasting or perhaps even permanent disabilities due to the severity of their injuries.
These long-term injuries may encumber recovering individuals for days, weeks, months, or even years after they are released from the hospital and may require expensive ongoing treatment to manage.
The Cost of a Motorcycle Accident Brain Injury
Traumatic Brain Injuries caused by motorcycle accidents result in an estimated $13 billion in medical expenses and associated financial impact in The United States. Each individual who suffers TBI in a motorcycle accident can expect to spend about $4 million throughout their lifetime because of the injury itself and the long-term effects.
The immediate cost of treating a brain injury can be staggering. Even the diagnostic testing (MRIs and CT scans) used to spot brain injuries can run into the tens of thousands of dollars. When you add in the additional non-medical expenses associated with recovering from a motorcycle accident brain injury the average victim can expect to pay around $151,000 out of pocket (according to The National Foundation of Brain Research).
However, motorcyclists may be able to seek financial assistance from at-fault parties. California law allows individuals injured by another person's carelessness, recklessness, or disregard for their safety to seek financial compensation for injuries, medical expenses, lost wages and more. Indeed, in the majority of motorcycle accidents in California involving other automobiles, the bike rider is not at fault.
Preventing Motorcycle Accident Brain Injury
Other than giving up the bike, the best and only way to protect yourself from a motorcycle accident brain injury is to wear a helmet. National Highway Traffic Safety Administration (NHTSA) research concludes that motorcyclists who don't wear helmets are three times more likely to die in the event of a crash than those who wear helmets. Additional research has concluded that simply wearing a helmet can reduce the risk of head injury by roughly 69% and decrease the likelihood of death by 42%. Other sources pin that injury prevention rate even higher at around 85%.
If you've suffered a TBI in a motorcycle accident caused by another individual, you could be entitled to financial compensation for your injuries. It may be time to get help from an experienced motorcycle accident attorney.