A traumatic brain injury (TBI) occurs when there is an alteration of brain function (e.g., loss or decreased level of consciousness, loss of memory for events immediately before—called retrograde amnesia—or after an accident—posttraumatic amnesia), or other evidence of damage to the brain. This damage is caused by something external (e.g., acceleration/deceleration of the brain during an accident or the head being struck).
The most frequent causes of severe traumatic brain injuries include car accidents, pedestrian accidents, bicycle accidents, truck accidents, and motorcycle accidents. Falls are also a major cause of traumatic brain injury.
Primary damage often includes contusions, lacerations, hematomas, and axonal injury. Other symptoms may follow the initial trauma and are referred to as secondary damage. This includes cerebral inflammation, ischemia (restricted blood/oxygen flow), elevated intracranial pressure, abnormal neurotransmitter release, and hormonal changes.
Due to strong rotational forces in an accident, axons may be stretched or twisted, causing diffuse axonal injury, a leading cause of death and disability in TBI victims.
The frontal and temporal lobes are often impacted by “coup and/or contrecoup” forces—when the brain moves rapidly within the skull.
TBIs rarely affect just one area of the brain. Serious cases usually involve widespread damage, resulting in multiple physical, cognitive, psychological, and social symptoms.
Treatment typically begins with acute hospital care, followed by inpatient and outpatient rehabilitation, and then reintegration into the community through programs such as ABI centres.
Severe TBI victims often experience posttraumatic amnesia. They may struggle with disorientation, confusion, and difficulties encoding new memories. Recovery usually involves a multidisciplinary team providing therapies such as physiotherapy, occupational therapy, speech therapy, neuropsychology, and more.
Schedules and treatment during hospitalization are typically dictated by staff. Short home visits may help transition patients back to family and community life.
Many TBI survivors suffer permanent cognitive deficits and behavioural changes that worsen over time. Severe TBI is now regarded as a chronic medical condition.
Long-term services may be needed post-rehabilitation. Some issues may lessen, but others worsen with age. The following sections outline the long-term consequences of severe TBI.
Common Sequelae after a TBI: Physical Issues
TBI can cause a wide range of physical issues, such as:
- Sensory impairments (e.g., visual disturbance, smell/taste alterations, hearing loss)
- Dizziness
- Balance problems
- Hemiparesis (weakness on one side)
- Movement disorders
- Bladder and bowel issues
- Problems with swallowing or appetite
- Sexual dysfunction
- Gait issues, vertigo, and tinnitus
TBI often co-occurs with other injuries (e.g., fractures). Compared to orthopedic injuries alone, TBI is linked to more physical disability and chronic pain—especially headaches, affecting over 50% of victims. These can become migraines, interfere with sleep, and cause fatigue.
Common Sequelae after a TBI: Cognitive Issues
Cognitive impairments are a hallmark of severe TBI. Attention deficits, slow processing speed, memory problems (short and long-term), and language issues are common.
Executive function problems (planning, organizing, judgment), and challenges with social cognition (interpreting cues, understanding emotions) may arise, deeply impacting social behavior.
Common Sequelae after a TBI: Behavioral and Personality Changes
Severe TBI can alter behaviour and personality. Symptoms include impulsivity, disinhibition, emotional lability, and poor self-regulation, which can strain relationships.
Some individuals become aggressive, irritable, or unpredictable, often alienating friends and family.
Common Sequelae after a TBI: Social Network and Relationship Strain
TBIs can disrupt families. Couples may face intimacy and communication issues. Families often take on more responsibilities, which can increase stress and lead to separation or divorce.
Common Sequelae after a TBI: Impact on Daily Activities, Quality of Life, and Social Participation
Because of the physical, emotional, and cognitive challenges associated with TBI, everyday tasks may become difficult. Quality of life and ability to engage in meaningful activities may decline drastically.
Brain Injury Compensation
If someone suffers a severe TBI due to negligence, they may be entitled to compensation. Treatment and rehabilitation are often lifelong. The team at Lalande Personal Injury Lawyers can help.
Here are some types of compensation you may be entitled to:
Housekeeping Damages: Compensation for loss of ability to perform household tasks (e.g., vacuuming, laundry, outdoor maintenance). Fatigue, pain, and reduced endurance may make such tasks difficult or impossible.
Future Care Damages: Covers healthcare not paid by OHIP—e.g., attendant care, physical therapy, occupational therapy, psychological care, speech therapy, neuro-optometry, etc.
General Damages (Pain and Suffering): Also known as non-pecuniary damages in Canada. These are awarded to compensate victims for physical and emotional pain, loss of enjoyment, and diminished quality of life.
In Stapley v. Hejslet, Judge Kirkpatrick listed factors that affect these awards:
- Age of the plaintiff
- Nature and severity of the injury
- Duration and extent of pain
- Disability
- Emotional suffering
- Impairment of relationships and lifestyle
- Loss of physical and mental abilities
- Stoicism (should not count against the victim)
These factors help judges assess fair compensation for pain, suffering and reduced enjoyment of life caused by the injury.
Economic Losses: if you are unable to work because of a severe traumatic brain injury, you may be entitled to claim compensation for your lost wages. The claim can be framed as what is called an “economic loss” or a “loss of economic opportunity.” In the normal course of events, our brain injury lawyers would obtain something called a vocational study or a vocational situational assessment, which typically outlines a client’s vocational history, job duties, responsibilities and requirements, vocational testing, a clinical review and an opinion as to whether or not the client is completely disabled from any suitable employment, given his or her neurocognitive functional limitations.
The person who is hurt is entitled to claim past wage losses up to the time of settlement or trial, as well as future wage losses until retirement. The wage losses are calculated by determining what he or she would’ve made if the injury had not occurred. Then, that financial assumption is reduced by money that the client actually receives, such as long-term disability or CPP disability.
If you or a loved one has suffered a severe brain injury, our brain injury lawyers can help.
Matt Lalande is a personal injury trial lawyer who has been representing brain injury victims and their families since 2003. We have seen firsthand that living with a traumatic brain injury is terribly life-changing. We have represented clients who have suffered severe cognitive consequences, severe psychological consequences, severe emotional consequences and severe physical consequences as a result of severe traumatic brain injuries.
Accident victims who have suffered very severe brain injuries need experienced and expert representation to help guide them through the legal system or the complex insurance system and to ensure that they recover the maximum compensation that they are entitled to receive. Financial protection is an absolute necessity for people who suffer traumatic head injuries – and our firm can make sure that you and your family are protected and are able to move forward comfortably in your financial affairs.
Call our brain injury lawyers today no matter where you are in Ontario at 1-844-LALANDE or local in the Hamilton / Niagara / Burlington region at 905-333-8888. Alternatively, you can chat with her live chat operator 24/7, and she will be pleased to ensure that you speak to us as soon as possible.