Even though there has been a major advancement in the recognition of concussion injuries, there remains significant misunderstanding of concussion injuries. The Schmidt Salita Law Team specializes in bringing justice to the victims of concussion injuries.
A concussion injury is a mild Traumatic Brain Injury (mTBI) but there is nothing mild about its severe impact in terms of incidence and severity in terms of lost function and total economics loss. The Center for Disease Control (CDC) estimates that there are 1.4 million TBIs which result in hospital and emergency department visits every year. 50% “fly under the radar”, never seeking medical attention. 75 to 90% of all TBIs fall into the mild category.
Yet, there is nothing mild about a “mild” TBI. That term is used in the medical literature to reference those TBIs that do not involve a skull fracture, a closed head injury without a hematoma or bleeding, and those that do not show positive organic damage on MRI or CT scanning.
The Concussion Report of the US Department of Veterans Affairs reports that the long term consequences of concussion injuries are, in the majority of cases, more serious than with moderate to severe brain injuries!!! Mild TBIs can often result in severe disability, including cognitive dysfunction, severe visual impairment, and severe balance and dizziness disorders. They can result in delayed major health problems, including delayed seizure disorders, Parkinson’s disease, early Alzheimer’s and dementia, and even infectious diseases.
The most respected Neuropsychologist states that “there is no such thing as a complete recovery from a concussion injury.” Respected studies reveal that the victims of a concussion injury are 3 times more likely to have a second concussion and the victims of a second concussion are 8 times more likely to have a third.
Concussions are a serious and overlooked problem. 60% of the clients of the Schmidt Salita Law Team who have been in a moderate to severe motor vehicle collision have suffered a concussion injury. A high percentage of those cases have been overlooked by the by the medical community. No wonder! The VA Concussion study determined that the symptoms of a concussion injury do not show up until 3-7 days after the trauma.
Concussions stand out as the most common type of traumatic brain injury and is known by many names in the medical industry. None of them sound good, mild brain injury, mild traumatic brain injury, minor head trauma, not a thing any of us want to see listed on our medical report. Our brains, after all, are us. Treatment is simple enough, you just have to chill out and rest both your body and your mind, which means no video games, no texting, and no school work. No, this isn’t a good way to get out of taking that final, Concussions can have some serious repercussions.
So Concussion Awareness Day is a chance to help yourself and others by learning how to identify the signs of a concussion and what to do in the event that someone you know sustains one, or you suspect they may have. As mentioned above, concussions are particularly common amongst those who engage in active sports, especially American Football and Boxing.
As seen in countless Saturday morning cartoons, a concussion is most often caused by a sudden direct blow or bump to the head.
The brain is made of soft tissue. It’s cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain. Sometimes, it literally causes it to move around in your head. Traumatic brain injuries can cause bruising, damage to the blood vessels, and injury to the nerves.
The result? Your brain doesn’t function normally. If you’ve suffered a concussion, vision may be disturbed, you may lose equilibrium, or you may fall unconscious. In short, the brain is confused. That’s why Bugs Bunny often saw stars.
A concussion injury is a mild Traumatic Brain Injury (mTBI) but there is nothing mild about its severe impact in terms of incidence and severity in terms of lost function and total economics loss. The Center for Disease Control (CDC) estimates that there are 1.4 million TBIs which result in hospital and emergency department visits every year. 50% “fly under the radar”, never seeking medical attention. 75 to 90% of all TBIs fall into the mild category.
Yet, there is nothing mild about a “mild” TBI. That term is used in the medical literature to reference those TBIs that do not involve a skull fracture, a closed head injury without a hematoma or bleeding, and those that do not show positive organic damage on MRI or CT scanning.
Yet, mild TBIs can often result in severe disability, including cognitive dysfunction, severe visual impairment, and severe balance and dizziness disorders. They can result in delayed major health problems, including delayed seizure disorders, Parkinson’s disease, early Alzheimer’s and dementia, and even infectious diseases.
The severity of concussion injuries has been overlooked for decades.
The horrible problem of Chronic Traumatic Encephalopathy has been overlooked for over 30 years. In 1986, the National Brain Injury Foundation (NBIF) called to public attention the fact that autopsy studies had provided proof positive that “even minor blows to the head” with only brief periods of unconsciousness could produce permanent damage to the brain. The evidence was ignored for 30 years until a study of 202 brains of professional football players revealed proof positive of “Chronic Traumatic Encephalopathy” (CTE). (Boston Globe. ???)
In 1996, the U.S. Congress recognized the problem and passed the Traumatic Brain Injury Act. In 2009, the Center for Disease Control attempted to educate the medical community, publishing “Heads Up-Facts For Physicians About Mild Traumatic Brain Injury (MTBI)”.
In spite of these heroic measures, the “Silent Epidemic” continues to be ignored.
In 2016, the Brain Injury Association of America acknowledged that (1) concussion injuries are not always understood as brain injury, (2) frequently not diagnosed or underdiagnosed, and (3) subsequent problems not associated with the concussion. (Guide)
Emergency room doctors acknowledge that they cannot reliably assess which patients will experience Post-Concussion Syndrome.
Recognizing this problem, the author’s law firm routinely screens new car accident victims for concussion. It has found that approximately 60% of the victims of moderate to severe car accidents have presumptive evidence of a concussion injury. Well more than ½ have not been diagnosed by a medical doctor or other health care provider. This is a problem of massive proportions.
Respected chiropractic literature has long recognized that the same forces that cause “whiplash of the spine” also cause “whiplash of the brain”, or concussion. The symptoms of both are quite common, especially headaches. The textbook, Whiplash Injuries-The Cervical Acceleration/Deceleration Syndrome, co-authored by Dr. Arthur Croft back in 2002 extensively discussed the relationship between spinal whiplash and brain whiplash. (Cite)
Foreman and Croft has long recognized that he assessment and treatment of concussion injuries is squarely within the scope of practice of chiropractic medicine. Concussion assessment is being taught in Chiropractic schools.
The Minnesota Chiropractic Practice Act specifically recognizes that the science of chiropractic includes “the relationship between structure and function as coordinated by the nervous system and how that relationship affects the preservation and restoration of health…and other pathology that results in pain or disturbances within the nervous system.” Yet, many Doctor of Chiropractic fail to employ concussion screening as an integral part of their standard practice.
Basic concussion screening is not difficult. Remember that the goal is not to reach a definitive diagnosis. Instead, it is simply to do a “quick and dirty” preliminary screen to look for presumptive evidence of a concussion that would call for a referral to a concussion expert. (Remember that 90% of the medical community does not fall in that category!)
Step #1: Ask detailed questions about the patient’s memory of the traumatic event, both before and after. Remember that loss of memory of details before the trauma is “anterograde amnesia” which is strong evidence of a TBI. Loss of memory of details after the trauma is “retrograde amnesia”, which is stronger evidence of a concussion than actual loss of consciousness.
Step #2: Ask about loss of consciousness (LOC). Remember that LOC can be total (coma) or partial (lethargy or stupor). Mere confusion or disorientation is a partial loss of consciousness sufficient to be evidence of a concussion injury.
Step #3: Use one of the well-recognized screening tools such as the Rivermead Post Concussion Questionnaire or the SCAT5. Either can be given to the patient for self-assessment in the waiting room and then reviewed with the Doctor during the examination.
Both the Rivermead and the SCAT5 ask the patient to identify classical symptoms of Post-Concussion Syndrome (PCS) such as headache, nausea, blurred vision, mental confusion, etc. and then to self-rate the severity of each.
Studies tell us that as many as 3 million concussion injuries fall through the cracks of the medical community. Doctor of Chiropractic are wonderfully situated to provide a safety net to those who seek chiropractic treatment. Let me share one success story of where a Doctor of Chiropractic was the “safety net” for a person whose severe concussion injury was totally ignored by the medical community:
Jamie’s Story
Jamie was stopped in rush hour traffic when her car was rear-ended at 30-40 mph by a huge semi-truck. Her car was totaled. The front bumper of the truck ended up in the back seat of her car.
She was evaluated at the Emergency Department of a local hospital with no concussion screening and discharged with no treatment recommendations.
Two days later, she presented at the Urgent Care Clinic of a major health care network, again complaining of “whole body pain”, again with no concussion screening. Five days later, she was seen by her primary care physician-again no concussion screening. Thankfully, her MD referred her to a Doctor of Chiropractic who took a history of the classic symptoms of a concussion injury: forgetfulness, loss of concentration, headache, dizziness, ears ringing, fatigue, depression, light sensitivity, and irritability-and diagnosed the concussion. A referral was made to one of the few medical doctors who are Board Certified in Traumatic Brain Injury Medicine confirmed the concussion diagnosed and instituted appropriate therapy.
As of this printing, Jamie remains unable to work for 5 months and has lost her job in a very high level professional occupation.
Conclusion: Doctors of Chiropractic can and should be the safety net for overlooked concussion injuries. Arthur Croft has long advocated that function as an integral part of the profession of chiropractic medicine. It is important that Chiropractors remain vigilant for concussion injuries. They have the opportunity to see concussion victims in a time frame that allows for a more reliable evaluation after the initial shock and acute physical symptoms that often overshadow immediate concussion evaluation.
The Schmidt Salita Law Team handles cases involving car accidents, trucking accidents, motorcycle accidents, pedestrian car accidents, and bicycle accidents. It has many years’ experience in workers , products liability and medical malpractice cases.
The Schmidt Salita Law Team has extensive experience with concussion injuries, traumatic brain injuries, neck and back injuries, whiplash injuries, broken bones, injured joint injuries (knee, hip, shoulder, wrist, ankle, spinal), amputation injuries, and vision and eye injuries.
The Schmidt Salita Law Team has offices through out the State of Minnesota. Its primary location is at Ridgedale Office Center in Minnetonka, near the intersection of I394 and I494. The offices are ground level, handicap accessible with ample parking.
The firm offers contingent fee agreements (You don’t pay lawyers fees until you collect and then only as a percentage of the settlement). It also offers home and hospital visits to clients whose injuries present difficulty in coming to the office.
The Schmidt Salita Law Team has locations throughout the Twin Cities metropolitan area of Minneapolis and St. Paul, as well as Minnetonka, Maple Grove, Plymouth, Osseo, Anoka, Coon Rapids, Brooklyn Center, Fridley, Blaine, Shoreview, Woodbury, Falcon Heights, Columbia Park, Stillwater, Hastings, Inver Grove, Cottage Grove, South St. Paul, Apple Valley, Eagan, Burnsville, Savage, Shakopee, Richfield, Bloomington, Chaska, Chanhassen, Edina, Eden Prairie, and Hopkins.
This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Dean M. Salita, with more than 30 years of legal experience as a personal injury attorney.
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