A Mild Traumatic Brain Injury/ Concussion May Not Be So Mild After All

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Hmm... the fact that you're reading this means that we have something in common. At the very least, perhaps, we have an interest in brain injuries. The most agreeable side of the spectrum would bet that you're a highly esteemed PI lawyer that is sick and tired of dealing with ignorant insurance carriers, and just about everyone else, downplaying the severity and potentially life-altering effects from your clients "mild" traumatic brain injuries (mTBIs). I know I am!

It is no secret- Traumatic brain injury (TBI) is a global health concern. More than 60 million people, globally, suffer a TBI every year. For reasons such as increase in falls in the elderly, armed conflict, sports-related injuries, and increased road traffic accidents, TBIs are on the rise. True enough, innovative technology has led to a reduction in TBI-related deaths, but at what expense? Increased survival rates simply mean there are more people, than ever before, living sub optimally with potentially debilitating lifelong conditions... that nobody believes they even have.

Contrary to popular belief, there is nothing "mild" about "mild" traumatic brain injuries (concussions); as they often lead to physical, psychological, and cognitive long-term repercussions. Repercussions that can really take a toll on individuals, their families, and society collectively. These detrimental malingerers are not exclusive to patients who have suffered severe TBIs. It is already known that TBIs have been associated with increased risk for neurological diseases, including dementia, Parkinson's disease, Alzheimer's disease, and epilepsy. TBI has also been hypothesized to be an independent risk factor for stroke, but until recently, no systematic reviews, pertaining to this hypothesis, were conducted.

Several students attending the University of Birmingham, Birmingham, UK, recently published an article regarding the newly-confirmed association between TBI and risk of stroke, stemming from a systematic review including a total of 2,606,379 participants. The resulting highlights are as follows:

• TBI patients have 86% increased risk of stroke compared to non-TBI participants.

• Stroke risk may be highest in the first 4 months post TBI but remains significant 5 years post-TBI.

• TBI is associated with increased stroke risk regardless of TBI severity or subtype.

• TBI is associated with increased risk of both ischemic and hemorrhagic stroke.

This article further explains, "Our findings suggest TBI is an independent risk factor for stroke regardless of TBI severity or subtype even if it is mild and patients experience a good recovery. This is particularly noteworthy as 70-90% of TBIs are mild (Turner et al., 2021)."

As a medical malpractice and personal injury certified legal nurse consultant, specializing in brain injury cases, articles like these are bittersweet. While the newly-confirmed finding is not positive, the message that it helps amplify- is:

• "Mild" in mTBI is a misnomer,

• Contrary to insurance carrier's preferences, there is nothing "straight forward" about mTBIs.

• MTBIs do not simply involve a single moment in time.

• Patient's symptoms are real and can last long-term.

• Just because the detrimental anatomical/ physiological changes may not be seen on early imaging, does not mean damage to the brain has not occurred.

...and

• The heightened predisposition to later comorbidities, including (now) stroke, is all the more reason to approach mTBIs with the seriousness they deserve and afford them the significance they demand.