Common Radiologic and Neuroimaging Techniques Like CT Scans and MRIs Often Fail to Show Mild Traumatic Brain Injuries or Concussions

 

Learn How to Overcome the Insurer’s Defense that Your Brain Injury is “Invisible”

 

Persuading an insurance adjuster, judge, or jury to pay damages for a head injury or a traumatic brain injury (TBI) often means showing that your cognitive abilities, personality, and behavior have changed since the work accident, construction site accident, car crash, or truck collision causing harm.

 

Your attorney may use several types of evidence to show these changes, including witness testimony, employment records, medical reports, school performance, and neuropsychological examinations.

 

But for some jurors, “seeing is believing.” They want to see actual damage to the brain before accepting your version of events.

 

Unfortunately, many of you who seek compensation for concussions or mild traumatic brain injuries cannot rely on standard imaging techniques like Computed Tomography (CT), Magnetic Resonance Imaging (MRI), or X-ray scanning to satisfy this need. These diagnostic imaging types are not sensitive or sophisticated enough to detect brain damage from all head injuries.

 

Having represented hundreds of brain injury victims in tort claims, workers compensation cases, and petitions for benefits through the Virginia Birth-Related Neurological Injury Fund, I know the lack of visual or objective evidence of brain damage is one of the most common defenses to TBI and concussion litigation. Insurance companies and their defense attorneys and medical experts use this lack of objective visual evidence to portray TBI victims as malingerers faking and exaggerating their symptoms to get more money.

 

This article discusses how to overcome this common defense to head injury cases and persuade the most skeptical claim adjuster, judge, or juror that your brain injury and the resulting symptoms are real.

 

Keep reading to learn more.

 

Then, call (804) 251-1620 or complete this online form to talk with a firm member about your legal rights and see if we will accept representation.

 

Is Diagnostic Imaging Used to Assess Brain Damage from Head Injury?

 

Yes.

 

Many of us become familiar with diagnostic imaging tests during childhood or after suffering an injury to a body part while playing sports or working. For example, X-rays, MRIs, and CT scans show orthopedic injuries like stress fractures, herniated discs, knee injuries (including torn ACLs or menisci), and rotator cuff tears not visible to the naked eye.

 

Similarly, medical providers use a variety of diagnostic tests to assess brain injury. The two most common imaging types following a head injury are:

 

    • CT scans remain the most widely used imaging type to evaluate acute head injuries. Their popularity stems from their low cost (compared to other imaging scans) and ability to give doctors information quickly.

    • MRIs can show more subtle trauma, such as contusions and hemorrhages, compared to CT scans.

 

The Problem: Many Mild Traumatic Brain Injuries are Invisible with CT and MRI Scans

 

Because of how effective conventional diagnostic testing is in detecting other types of personal injuries and medical conditions, there is a common belief that if a person has suffered a traumatic brain injury, then today’s diagnostic tests will detect that brain injury. Otherwise, there is no brain injury.

But this belief, held by many in the general public and some practicing physicians and attorneys, is wrong.

 

Mild traumatic brain injuries are often impossible to visualize with CT or MRI scans. Many people with head trauma causing post-concussive syndrome and long-lasting symptoms will have negative (normal) CT and MRI results.

 

As stated by Dr. M.P. Alexander in his article Mild Traumatic Brain Injury: Pathophysiology, Natural History and Clinical Management, 45 Neurology 1253, 1253 (1995): “By common clinical agreement, neuroimaging studies are negative” for many mild traumatic brain injury patients. Other experts in brain injury medicine support this view, stating that many patients with a history of brain injury will have evidence of functional impairment even though their MRIs and CT scans may not show abnormalities.

 

Recent studies have concluded that CT scans and MRIs cannot rule out mild traumatic brain injury because they often lack the sensitivity to identify damage to the brain. Some of these researchers and other medical experts have gone one step further and indicated that a patient reporting head trauma should only undergo diagnostic imaging if they had a loss of consciousness, a penetrating injury, an abnormal Glasgow Coma Scale (GCS) or Rancho Los Amigo Scale score, or a suspected skull fracture.

 

How to Overcome the Invisible Injury Stigma: What Can I Do if the CT or MRI Fails to Show Brain Damage?

 

When you appear fine physically and cannot show an insurance adjuster, defense attorney, or juror a photograph or standard imaging tests to prove you suffered a mild traumatic brain injury, you must rely on other evidence to show that you are struggling post-accident.

 

Due to years of insurance company propaganda meant to persuade Americans (the juror pool) that many plaintiffs are greedy and exaggerate their symptoms, I find this evidence necessary to negotiate a fair car accident settlement or win at trial.

 

First, consider undergoing imaging with one of the newer techniques. Medical researchers continue to develop and improve tests with greater sensitivity that may show damage to your brain. Examples of these advanced imaging tests include volumetric analysis, diffusion magnetic resonance imaging, neurite orientation dispersion and density imaging, positron emission tomography (PET), arterial spin labeling, and others.

 

Second, overcoming this skepticism requires preparation, aggressive pretrial discovery to build your case’s theory, strong opening and closing statements at trial, and witnesses to “objectify” the brain injury’s harm as best as possible.

 

 This presentation and testimony should focus on enhancing your:

 

    • Likeability: Fair or not, whether the adjuster or defense attorney thinks the judge or jury will like you affects your case’s value. The jury will look for reasons to award damages if it likes you, even if you do not have objective visual evidence showing brain damage.

 

    • Credibility: Even when the defendant’s negligence is undisputed, or the insurance company concedes you suffered head trauma, the insurer may dispute the workers compensation benefits or compensatory damages you should receive. The insurer may point out that you “look normal” and argue that your complaints about decreased cognitive functioning, headaches, or memory loss are fake or exaggerated. It may even allege that your current symptoms are the result of mental health problems that existed before the accident at the center of your case, especially if you have a documented history of anxiety, depression, or PTSD. You can fight back against these allegations with before and after witnesses (people who can testify to your abilities before the mild TBI vs. after), expert medical witnesses, your testimony, and school and employment records that show you were functioning normally before the TBI but now have serious problems.

 

It should also educate the jury on the following:

 

    • How you injured your brain, particularly if you did not strike your head in the traumatic incident

 

    • How the healthcare profession diagnoses mild brain injury and the limits of conventional diagnostic imaging tests in showing that a person suffered a concussion

 

    • Common symptoms of TBI. Your testimony, the testimony of other witnesses, and your medical records and reports should show that you have suffered these symptoms since the initial accident.

 

    • The short – and long-term consequences of mild traumatic brain injury, both at home and at work.

 

    • Your limitations with your current symptoms. For example, you may be able to function normally, but only for short periods with lots of rest in between. Or you can work regular hours in a highly structured and routine environment with limited social interaction, causing a decrease in earnings. Your doctor needs to explain why this is.

 

    • What your recovery will look like, and what future medical treatment you may need. Make sure you itemize the costs of this care.

 

Your attorney may even use a day-in-the-life video during mediation or trial to show your struggle with mild TBI symptoms more effectively than your trial testimony may do.

 

Get Help from an Experienced Mild TBI Lawyer When the Diagnostic Tests Don’t Help

 

Many people are unable to recognize when a friend, family member, or acquaintance is struggling with a mild traumatic brain injury. So, it is no surprise that insurance adjusters and jurors are sometimes hesitant to pay or to award a fair amount for your traumatic brain injury caused by someone else’s negligence or a work accident when they cannot see direct evidence of the injury itself.

 

But with the help of an experienced brain injury attorney, a team of expert witnesses, and before and after witnesses who know you best, you can overcome this hesitation and win your claim – even when the MRI and CT scans show no damage.

 

Call now for help: (804) 251-1620.

Corey Pollard
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