This article follows on from our TBI recent features by Shoosmiths: Brain injury: Symptoms, signs and the mechanism of injury in road traffic accidents and Chris McKinney: Traumatically induced brain injuries resulting from road traffic accidents.
The immediate requirement will be to stabilise the patient by treating the immediate symptoms and establishing an accurate diagnosis to establish the extent of damage caused. After immediate treatment and stabilisation, the following diagnostic testing will take place to ascertain the injury to the head:
- Position emission tomography (PET)
- Magnetic Resonance Imaging (MRI)
- Electroencephalograms (EEG)
- Glasgow Coma Scale (GCS) – establishes level of consciousness post accident
Whilst these tests will identify a medical emergency, they're limited in establishing the severity of brain injury and future prognosis.
Treatment will be dependent on the severity of injury caused. Minor head injuries may require monitoring the hospitalised patient for short periods, and providing medication to reduce swelling and pain, and to reduce the risk of seizures.
Moderate to severe head injuries, such as open head traumas, penetrating, crushing or fracture wounds to the skull may, require immediate surgery. Post-operatively, and following stabilisation, more diagnostic tests take place to determine the extent of cognitive functional damage.
Neuropsychological testing is usually undertaken by a neurologist or neuropsychologist specialising in cognitive motor testing. This helps identify brain abnormalities. These tests are lengthy and may need to be repeated several times to eliminate outside factors such as depression, distraction or fatigue before providing an accurate result.
Severe head injuries require lengthy periods of hospitalisation and rehabilitation. Unfortunately, return to the pre-accident status is rarely attained.
The most common brain injury is concussion, which happens when the brain is shaken violently or rattled within the skull, causing changes in cognitive functioning.
Diagnosis for concussion is usually determined by physicians using objective and subjective findings. Diagnostic testing doesn't detect changes in cognitive function. A patient suffering concussion will usually have lost consciousness for a short period or appear dazed and disorientated. They're likely to suffer headache, vertigo, disorientation and nausea. If symptoms continue they're likely to experience light headedness, poor attention span, reduced concentration, memory dysfunction, difficulties with vocabulary or simple mathematical equations, fatigue, slow reaction time and changes in personality.
Concussion may result in irreversible brain damage, so physicians usually focus attention on minimising further damage to the delicate brain cells during the recovery period. During this period changes in cerebral blood flow, blood pressure or pressure within the brain can all contribute to brain damage following a concussive injury, so it's important to minimise changes in these areas.
Concussive injuries usually require minimum hospitalisation. After stabilisation and once the physician is satisfied that all the risk factors are within normal limits, the patient is sent home to recover. Advice is usually given to relatives to reawaken the patient regularly to confirm a conscious state.
Once home, treatment offered may vary. Shoosmiths can help by arranging rehabilitation under the Rehabilitation Code.
Early post-hospitalisation treatment may be essential in assisting the patient's chances of improving cognitive function and, in more severe head injuries, physical ability. Speech therapy, cognitive behavioural therapy and physiotherapy may be some of the treatments required.
We can also approach the opponent's insurers to seek agreement for a case manager to be appointed under the Rehabilitation Code, who will assess the patient, liaise with treating physicians, and coordinate treatment on a private basis.
A case manager may also liaise with family members to help them to assist in the patient's rehabilitation. For more severe injuries, treatment in a specialist rehabilitation unit maybe required, and a case manager could assess the requirement for this and make the necessary arrangements.
For more information regarding brain injury claims, visit our page.
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024
"Kama ilivyoelezwa katika makala ya hivi karibuni ya TBI ya Shoesmiths, ""Uharibifu wa Ubongo: Dalili, Ishara na Utaratibu wa Uharibifu katika Ajali za Trafiki ya Barabara"" na ""Uharibifu wa Ubongo wa Traumatic Uchochezi unaotokana na Ajali za Barabara.""" "Hatua ya kwanza ni kumfanya mgonjwa awe na afya nzuri kwa kutibu dalili za mara moja na kuanzisha utambuzi sahihi ili kuamua kiwango cha uharibifu uliosababishwa.""" Baada ya matibabu ya haraka na utulivu, vipimo vifuatavyo vya utambuzi vinafanyika ili kuamua jeraha la kichwa: - Tomografia ya Emission ya Nafasi (PET) - Magnetic Resonance Imaging (MRI) - Electroencephalogram (EEG) - Glasgow Coma Scale (GCS) - huanzisha kiwango cha ufahamu baada ya ajali. Matibabu yatategemea uzito wa jeraha lililosababishwa. Majeraha madogo ya kichwa yanaweza kuhitaji ufuatiliaji wa mgonjwa aliye hospitalini kwa vipindi vifupi, na kutoa dawa ili kupunguza uvimbe na maumivu, na kupunguza hatari ya mshtuko. Majeraha ya kichwa ya wastani hadi kali, kama vile majeraha ya kichwa wazi, kupenya, kuvunja au majeraha ya kuvunjika kwa fuvu la kichwa, yanaweza kuhitaji upasuaji wa haraka. Baada ya upasuaji, na baada ya utulivu, vipimo zaidi vya utambuzi hufanyika ili kuamua kiwango cha uharibifu wa utendaji wa utambuzi. Upimaji wa neuropsychological kwa kawaida hufanywa na mtaalamu wa neva au neuropsychologist maalumu katika upimaji wa motor cognitive. Hilo husaidia kutambua kasoro za ubongo. Uchunguzi huu ni mrefu na unaweza kuhitaji kurudia mara kadhaa ili kuondoa mambo ya nje kama vile unyogovu, kukosa fikira au uchovu kabla ya kutoa matokeo sahihi. Majeraha makali ya kichwa huhitaji vipindi virefu vya kulazwa hospitalini na kurekebishwa. Kwa kusikitisha, ni mara chache sana kwamba mtu anaweza kurudi hali yake ya kabla ya aksidenti. Uharibifu wa ubongo wa kawaida ni mshtuko wa ubongo, ambao hutokea wakati ubongo unatikiswa kwa vurugu au kutikiswa ndani ya fuvu la kichwa, na kusababisha mabadiliko katika utendaji wa utambuzi. Kwa kawaida madaktari huamua ugonjwa wa mshtuko wa ubongo kwa kutumia matokeo ya kimakusudi na ya kibinafsi. Uchunguzi wa utambuzi hauguni mabadiliko katika utendaji wa utambuzi. Kwa kawaida mgonjwa anayepatwa na mshtuko wa ubongo hupoteza fahamu kwa muda mfupi au huonekana kuwa amechanganyikiwa na kutokuwa na mwelekeo. Wanaweza kuugua maumivu ya kichwa, vertigo, kutoelewana na kichefuchefu. Ikiwa dalili zinaendelea, huenda wakapata maumivu ya kichwa, upungufu wa umakini, kupungua kwa umakini, matatizo ya kumbukumbu, ugumu wa kutumia msamiati au hesabu rahisi za hisabati, uchovu, muda wa kuchelewesha na mabadiliko ya utu. Mshtuko wa ubongo unaweza kusababisha uharibifu wa ubongo usioweza kubadilika, kwa hivyo madaktari kwa kawaida hukazia uangalifu juu ya kupunguza uharibifu zaidi kwa seli nyembamba za ubongo wakati wa kipindi cha kupona. Mabadiliko katika mtiririko wa damu ya ubongo, shinikizo la damu au shinikizo ndani ya ubongo inaweza kuchangia uharibifu wa ubongo baada ya jeraha la concussion, kwa hivyo ni muhimu kupunguza mabadiliko katika maeneo haya. Kwa kawaida majeraha ya mshtuko wa akili huhitaji kulazwa hospitalini kidogo. Baada ya kutulia na mara tu daktari anashikamana kwamba sababu zote za hatari ziko ndani ya mipaka ya kawaida, mgonjwa hutumwa nyumbani kupona. Kwa kawaida watu wa ukoo hushauriwa kumwamsha mgonjwa kwa ukawaida ili kuthibitisha kwamba yuko katika hali ya ufahamu. Baada ya kurudi nyumbani, matibabu yanayotolewa yanaweza kutofautiana. Watengenezaji wa viatu wanaweza kusaidia kwa kupanga ukarabati chini ya Kanuni ya Urekebishaji. Matibabu ya mapema baada ya kuingizwa hospitalini yanaweza kuwa muhimu katika kusaidia nafasi za mgonjwa kuboresha kazi ya utambuzi na, katika majeraha makubwa ya kichwa, uwezo wa kimwili. Tiba ya hotuba, tiba ya tabia ya utambuzi na tiba ya mwili inaweza kuwa baadhi ya matibabu yanayohitajika. "Tunaweza pia kukaribia wawekezaji wa mlinzi kutafuta makubaliano kwa meneja wa kesi kupewa chini ya kanuni ya ukarabati, ambaye atathmini mgonjwa, kuwasiliana na madaktari wa matibabu, na kuratibu matibabu kwa msingi wa kibinafsi. """ Msimamizi wa kesi anaweza pia kuwasiliana na wanafamilia ili kuwasaidia kusaidia katika ukarabati wa mgonjwa. Kwa majeraha makubwa zaidi, matibabu katika kitengo cha kitaalamu cha ukarabati inaweza kuhitajika, na meneja wa kesi anaweza kutathmini mahitaji ya hii na kufanya mipango muhimu. Kwa habari zaidi kuhusu madai ya jeraha la ubongo, tembelea ukurasa wetu. Habari hii ni kwa madhumuni ya elimu tu na si ushauri wa kisheria. Inashauriwa kwamba ushauri maalum wa kitaalamu utafutwa kabla ya kutenda juu ya habari yoyote iliyotolewa. Shirika la Shoesmiths LLP