Severe Brain Injury - Medical Malpractice Lawyers

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Severe Brain Injury - Medical Malpractice

Severe traumatic brain injury is one in which there is usually loss of consciousness, coma and some permanent brain injury, including seizures, motor deficits and speech deficits. They are rated according to the Glasgow coma scale. Mild brain injuries have a Glasgow coma scale of more than 12. A scale rating of around 9-12 is a moderate brain injury and a scale of between 3-8 lasting greater than six hours with coma is considered a severe brain injury even if the patient wakes up after that.

Severe brain injuries can result from falls, motor vehicle accidents, or sporting accidents. Any severe blow to the head can result in a severe brain injury. The impact of a severe traumatic brain injury depends on the severity of the initial injury, where in the brain the injury is the worst, the degree of recovery from the injury and the parts of the body affected by the injury. If there is physical therapy, occupational and speech therapy available, the patient does better than if they are allowed to languish.

Severe brain injury can involve many brain functions, including memory, attention, concentration, confusion, speech perseveration, impulsiveness, cognitive function and brain processing of language, including things like counting, reading and manipulating memory.

If speech or language is impaired, there can be difficulty understanding the spoken word, known as receptive aphasia. There can be difficulty in producing speech or in being able to have their speech understood. This is called expressive aphasia. The inability to do either is called pure aphasia. There can be slurring of the speech, changes in the speed of speech, and problems with reading and writing. Sensory difficulties can also be the case and there can be problems with the perception of sensory input.

In severe traumatic brain injury, there can be total or partial loss of vision. Double vision is possible and the patient can have problems with judging distances. Involuntary eye movements called nystagmus can occur. Hearing can be reduced or lost completely. There can be permanent tinnitus or ringing in the ears as a result of brain damage to the temporal lobe. Taste and smell can be permanently affected as well.

Seizures and epilepsy can be a permanent complication of severe traumatic brain injury. It depends on which nerves are affected and which part of the brain is affected. You can get chronic pain, particularly chronic headaches. There can be permanent paralysis or spasticity, poor stamina, difficulty sleeping, loss of bowel or bladder control, difficulty controlling the temperature of the body and a poor appetite.

There can be problems with emotional and social disability. Some become overly dependent on others with clingy behavior. Others have social disinhibition, depression and a lack of motivation.

Severe traumatic brain injury is determined by a 15 point Glasgow coma scale. It is an estimate of the degree of coma and predicts outcome to some extent. The test is a specific measure of eye opening response, verbal response and motor response and can be done at the time of the injury or at any point along the course of the injury. Let's take a look at the Glasgow coma scale to see what the point levels mean:

Motor Response:

6 - Obeys commands fully

5 - Localizes to noxious stimuli

4 - Withdraws from noxious stimuli

3 - Abnormal flexion, i.e. decorticate posturing

2 - Extensor response, i.e. decerebrate posturing

1 - No response

Verbal Responsiveness

5 - Alert and Oriented

4 - Confused, yet coherent, speech

3 - Inappropriate words and jumbled phrases consisting of words

2 - Incomprehensible sounds

1 - No sounds

Eye Opening response:

4 - Spontaneous eye opening

3 - Eyes open to speech

2 - Eyes open to pain

1 - No eye opening

The total Glasgow coma scale is made by adding the three components of the scale. The number helps doctors and EMS workers to gauge the degree of coma and decides whether or not the individual has a severe traumatic brain injury. The more severe the injury initially, the worse the prognosis is for severe traumatic brain injury. A vegetative state is the poorest prognosis and represents a Glasgow coma scale of less than 3. As mentioned, a level of 3-8 represents a coma and a severe traumatic brain injury. In brain death, there is no electrical brain activity noted.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here