Brain Injury Lawyer Vancouver
Brain Injury or Closed Head Injury
Brain Injury may be mild, moderate or severe.
Mild brain injury may result from a blow to the head, with no or minimal loss of consciousness. It may leave no lasting effects, or may result in permanent deficits that impair one’s ability to think, remember, concentrate, work, control one’s emotions and function in society. It is the most contentious type of brain injury to prove in a litigation context.
Moderate brain injury results from a blow to the head with extended loss of consciousness and frequently results in permanent deficits that impair one’s ability to think, remember, concentrate, work, control one’s emotions and function in society.
Severe brain injury is the most catastrophic and is the easiest to prove in a litigation context. It invariably results in permanent deficits that disable one’s ability to think, remember, concentrate, work, control one’s emotions and function in society.
All head injuries are normally involved in cases of moderate, severe and frequently even minor brain injuries. Reports from neurologists, neurosurgeons, neuropsychologists, occupational therapists, vocational consultants, economists and other specialists are normally required to establish full recovery in cases of brain injury.
Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
Glasgow Coma Scale
The Glasgow Coma Scale (GCS) defines the severity of a TBI within 48 hours of injury.
- Spontaneous = 4
- To speech = 3
- To painful stimulation = 2
- No response = 1
- Follows commands = 6
- Makes localizing movements to pain = 5
- Makes withdrawal movements to pain = 4
- Flexor (decorticate) posturing to pain = 3
- Extensor (decerebrate) posturing to pain = 2
- No response = 1
- Oriented to person, place, and date = 5
- Converses but is disoriented = 4
- Says inappropriate words = 3
- Says incomprehensible sounds = 2
- No response = 1
The severity of TBI according to the GCS score (within 48 h) is as follows:
- Severe TBI = 3-8
- Moderate TBI = 9-12
- Mild TBI = 13-15
Ranchos Los Amigos Scale of Cognitive Functioning
The severity of deficit in cognitive functioning can be defined by the Ranchos Los Amigos Scale.
- level I = No response
- level II = Generalized response
- level III = Localized response
- level IV = Confused-agitated
- level V = Confused-inappropriate
- level VI = Confused-appropriate
- level VII = Automatic-appropriate
- level VIII = Purposeful-appropriate
TBI defined by the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine
The Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine defines mild head injury as “a traumatically induced physiologic disruption of brain function, as manifested by one of the following:
- Any period of loss of consciousness (LOC),
- Any loss of memory for events immediately before or after the accident,
- Any alteration in mental state at the time of the accident,
- Focal neurologic deficits, which may or may not be transient.”
The other criteria for defining mild TBI include the following:
- GCS score greater than 12
- No abnormalities on computed tomography (CT) scan
- No operative lesions
- Length of hospital stay less than 48 hours
The following criteria define moderate TBI:
- Length of stay at least 48 hours
- GCS score of 9-12 or higher
- Operative intracranial lesion
- Abnormal CT scan findings