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Severe Traumatic Brain Injury
Thousands of clinical compensation claims are initiated every year in the United Kingdom by medical negligence solicitors on behalf of people from all walks of life. A multitude of operations and procedures are executed successfully however a small percentage do go wrong, laying the grounds for medical negligence solicitors to take legal action in order to claim compensation. Both legal aid and the no win no fee scheme are available to pursue medical negligence compensation claims.
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Brain Injuries can be mild or severe. Severe brain injuries can result in permanent brain damage, coma and seizure disorders. Brain injuries are rated according to the Glasgow Coma Scale, which will be described below. Moderate brain injuries have a Glasgow Coma Scale of about 9 to 12 and results in a loss of consciousness of between twenty minutes and six hours. A severe brain injury is defined as having a Glasgow Coma Scale of between 3 and 8 and a loss of consciousness of greater than six hours. This loss of consciousness is known as a coma.
The impact of a severe brain injury depends on a number of factors including how severe the initial injury was, what degree of recovery of lost functions occurs, which functions of the brain are affected, what the dysfunction means to the affected injury and the areas of the body not affected by the severe traumatic brain injury. The resources available to the individual to help recovery make a big difference in the outcome of the brain injury.
Many brain functions can be affected in a traumatic brain injury. These include attention and concentration, memory, the presence of confusion, perseveration of speech, impulsiveness, processing abilities of language and cognitive function, such as counting, reading and manipulating memory.
There can also be problems with language and speech functioning. The person can fail to understand the spoken word in a condition known as aphasia. They can have difficulty with speech and word finding in expressive aphasia. They can have slurred speech, changes in the rates of speech and difficulty with reading and writing. There can be sensory difficulties, which assess touch, temperature and movement. There can be problems in perception, which make it difficult to integrate sensations the individual takes in.
Partial or total loss of vision can occur as well as double vision, blurry vision, problems judging distances and involuntary eye movements, such as nystagmus. There can be problems tolerating bright lights. Hearing can be lost or diminished. There can be permanent ringing of the ears or even increased sound sensitivity. One can lose the ability to smell things. Taste sensation can be diminished.
Seizures or the formation of actual epilepsy can be a side effect or symptom of having a severe traumatic brain injury. It all depends on the places in the brain that are affected and the degree to which they are affected. Chronic pain is a problem, such as chronic headaches. The individual can have trouble sleeping, poor stamina, paralysis or spasticity, loss of ability to control one's bladder or bowel, and problems with appetite and the regulation of temperature of the body.
Social and emotional problems can arise, including becoming overly dependent on others, having emotional lability, a lack of motivation, depression, aggression or disinhibition.
The Glasgow Coma Scale is based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others.
The test measures the motor response, verbal response and eye opening response with these values:
I. Motor Response
6 - Obeys commands fully
5 - Localizes to noxious stimuli
4 - Withdraws from noxious stimuli
3 - Abnormal flexion, i.e. decorticate posturing
2 - Extensor response, i.e. decerebrate posturing
1 - No response
II. Verbal Response
5 - Alert and Oriented
4 - Confused, yet coherent, speech
3 - Inappropriate words and jumbled phrases consisting of words
2 - Incomprehensible sounds
1 - No sounds
III. Eye Opening
4 - Spontaneous eye opening
3 - Eyes open to speech
2 - Eyes open to pain
1 - No eye opening
The final score is determined by adding the values of I+II+III.
This number helps medical practitioners categorize the four possible levels for survival, with a lower number indicating a more severe injury and a poorer prognosis. A number between 3 and 8 indicates a severe traumatic brain injury and identifies a coma. A vegetative state is a number less than three and is sometimes persistent, lasting longer than a month. In brain death, there is no electrical brain function and no brain reflexes are present.
Severe traumatic brain injury can happen anytime someone is in a severe car accident, has a sports-related fall or any other fall that traumatizes the function of the brain.