Effects and symptoms of brain injury
A brain injury can have a devastating effect and cause a wide range of different symptoms. In this article, Moore Blatch Associate Solicitor, Matthew Tuff, explores the most common effects and symptoms:
This is a common symptom of brain injury. People often feel exhausted much more easily than they did before the accident. The cause of this is not completely clear, but it may occur partly because of the extra effort required to carry out even simple tasks such as walking or talking. After a brain injury, the brain may work less efficiently than before.
Brain injury commonly causes cognitive impairments, such as worsened short term memory, difficulty paying attention and problems processing information. They may forget things that happened only the day before; or keep on repeating the same story, having forgotten that they have told that story several times. As a result of problems concentrating, they may find it difficult to read a book or magazine, or to watch a film from beginning to end.
People may find it hard to follow a conversation, particularly if they are speaking to more than one person at the same time.
They oftenexperience apathy and lack of motivation to carry out activities. This can be confused with laziness by those who do not know about brain injury.
It is not uncommon to have difficulty with planning, anticipating potential obstacles and deciding upon a logical sequence for tasks (for example planning a journey, trying to solve a problem or decide on the correct order in which to carry out a meal preparation). A person may find it hard to weigh up information and make a decision based on that information.
A common symptom is a tendency to ‘think rigidly’, an inability to think flexibly or consider alternative viewpoints.
A brain injury often causes behavioural issues of varying degrees. This can include impulsive behaviour, acting inappropriately in public (such as making offensive observations about complete strangers or sexual comments), feeling emotional and tearful, or outbursts of temper. One consequence of this is that people may find themselves getting into arguments or fights when they have lost their temper or offended some one. Paranoid thinking also be an effect of a traumatic brain injury.
The effects can be so significant that relatives or friends often say that the personality of the brain injury survivor has changed since the accident.
One less common side effect of brain injury is something called ‘pseudobulbar affect’, which can cause sudden episodes of uncontrollable crying that occurs even though the person may not feel particularly sad or a laughter outburst that occurs when they do not feel happy.
People sometimes find that a brain injury affects their balance. They may experience ‘vertigo’ and dizziness, or find that their ability to walk or drive in a straight line is impaired. One condition that may develop as a result of head trauma is Benign Paroxysmal Positional Vertigo (or BPPV). The vestibular system in the inner ear contains ‘crystals’ that help detect movement by sending signals to the brain. BPPV is caused by the crystals being dislodged and moving out of position. Sufferers can experience vertigo when moving their head or even when lying down or turning over in bed. This can often be treated by a procedure called the Epley Manoeuvre (which involves repositioning the crystals).
Injury to the brain can increase the risk of developing epileptic seizures (although the longer time passes after a brain injury, the more the risk normally decreases). In many cases, epilepsy can successfully be treated by medication.
Facial Recognition and Communication Problems
A brain injury survivor may find it harder to recognise the faces of people that they knew before the accident and this can be wrongly confused with rudeness. This symptom can be caused by damage to the temporal lobe in the brain (which helps with the ability to recognise faces).
Individuals may also have difficulty communicating, understanding language and expressing thoughts through language. They may also have difficulties with reading, writing and mathematics.
People may have vision problems after a head injury, such as blurred or double vision. This can be caused in various ways, such by damage to the optic nerve tract, cranial nerves or the occipital lobe (which is a lobe towards the back of the brain and which helps with processing information received from the eyes).
One not very surprising symptom of a head injury is headaches. These can vary in degree and sometimes people find themselves suffering with migraines.
An individual may also suffer with ‘neuropsychiatric’ symptoms such as anxiety and low mood. They may have insomnia. Unfortunately, these can interact with cognitive and behavioural symptoms. For example, if a person is anxious or depressed, this can make it more challenging to focus or concentrate, in turn making it harder to process or remember information. It can exacerbate feelings of paranoia. If you are having disturbed sleep this will make any excessive fatigue even worse.
Having access to rehabilitation or treatment as early as possible after a brain injury is crucial. At Moore Blatch’s Major Trauma Service, arranging rehabilitation for our clients with serious injuries is a high priority. At the outset of the claim, we invite the Defendant’s insurance company to agree to fund treatment for the injured party in order to achieve the best medical outcome. This could include treatment by a neuropsychologist, neuropsychiatrist, speech and language therapist, neuro occupational therapist and neurophysiotherapist (an occupational therapist’s role includes helping people return to everyday functions and activities; a neuro occupational therapist is an occupational therapist who works with brain injury survivors).
In addition, Solicitors at Moore Blatch are Trustees for Headway South West London and Headway Southampton – charities that support brain injury survivors and their families.
A Degloving injury is a severe injury where the outer skin becomes separated from the tissue underneath. Degloving injuries of legs, hands and arms are the most common. Degloving injuries of the head or torso are normally fatal. In this article, Moore Blatch Associate Solicitor, Matthew Tuff, discusses the causes of this particularly distressing injury and explores how the Moore Blatch Major Trauma Service can help on the road to rehabilitation.
Types of Degloving injury
Degloving injuries can be divided into two types – open degloving injuries and closed degloving injuries.
An open degloving injury is where the skin becomes detached and completely torn away from the underlying tissue and muscle, rather like if you imagine a glove on a person’s hand and it is gradually removed in a ‘peeling action’ so that the glove is left inside out.
With a closed degloving injury, the skin and upper level of tissue becomes separated from the deeper tissue, however the skin remains in place, which means that the degloving injury can be harder for the doctors to spot. Often the only visible symptom is a bruise. An MRI scan may be needed to confirm the diagnosis. Closed degloving injuries are much rarer than open injuries.
Degloving injuries often occur in accidents involving heavy machinery. In road traffic accidents, for example, they are often seen amongst cyclists or pedestrians that are involved in collisions with vehicles. They are often accompanied by fractures to the underlying bones, although not always. It is not unusual to see these injuries where a cyclist is run over by a lorry; the tyres are made of a tough material that grips the skin and pulls it away from the deeper tissue.
In accidents at work, degloving injuries may be caused by contact with conveyor belts or roller machines. They usually affect the upper limbs and may also be accompanied by a brachial plexus injury.
Degloving injuries usually necessitate extensive surgery. This may involve skin grafts or revascularisation operations. These injuries often lead to significant blood loss and death of the underlying tissue. More severe injuries may lead to the need for amputation.
At the Moore Blatch Major Trauma Service, we support many individuals with degloving injuries. At the outset of the claim, our focus is to assist the patient meet any rehabilitation needs over and above those that are met by the NHS. When the patient is discharged from hospital victims may find that the support from the statutory services falls away quite sharply even though the patient would benefit from further treatment and equipment. We work hard to ensure that funding is in place to allow treatment to continue and to enable the patient to achieve the best outcome possible.
Headway South West London
Headway South West London (HWSWL) is a dedicated charity that helps individuals with brain injury, and their families and carers, across the boroughs of Merton, Kingston, Sutton, Croydon, Richmond and Wandsworth. It provides monthly support meetings for brain injury survivors in Wimbledon, Richmond, Croydon and Balham, a free telephone advice service for social security benefits, an allotment and social trips (to places such as restaurants, the seaside and zoo) every two months.
I, together with two of my colleagues, have been involved with HWSWL for a number of years. Trevor Sterling, Partner at Moore Blatch, is Deputy Chairman of HWSWL. Eman Hassan, Solicitor in the Major Trauma Service at Moore Blatch, is a Trustee. I was a Trustee for many years and continue to assist the Board of Trustees. All three of us specialise in injury claims involving severe brain injuries and it is a pleasure to be able to work with a charity that does crucial work for individuals with brain injuries and their families.
Moore Blatch has a long and proud association with Headway. Martin Usher, who is an Associate Solicitor in the Serious Injury Department, is Chair of Headway Southampton.