Signs and Symptoms of a Brain Injury After a Car Accident

There is nothing mild about a mild-traumatic brain injury

Car accidents are one of the leading causes of traumatic brain injury, as the high velocity impact of a motor vehicle collision can cause an extremely forceful blow to the head. When the head suffers a blow, the brain shifts and can collide against the sides of the skull, causing injuries such as nerve damage, hemorrhage, skull fractures, cell damage, broken blood vessels, or a concussion (brain bruising).

Other types of motor vehicle accidents can cause a brain injury as well, such as pedestrian accidents, trucking accidents, motorcycle accidents, and bicycle accidents. Between 2011 and 2017, Health Canada reports that 67.1% of pedestrian accident victims suffered a traumatic brain injury, while 30% of bicycle accidents result in brain injury as well. 

Traumatic brain injury is typically classified into three core types depending on the severity of the damage and symptoms. These classifications are mild, moderate, and severe. In this article, our Hamilton Brain Injury Lawyers focus on the symptoms of a “Mild Traumatic Brain Injury” (MTBI) after a car accident.

What is a Mild Traumatic Brain Injury?

A mild traumatic brain injury (MTBI) is defined as a blow or jarring of the head that results in a disruption of brain functioning. MTBI has been labeled the “Silent Epidemic” or the “invisible injury”. Mild traumatic brain injuries are usually called “closed head injuries” because there is a non-penetrating injury to the brain. This type of injury can be caused by serious whiplash or hitting the head, resulting in bruising, stretching, and shearing of the axons and/or tearing of the tissues – all of which can happen in a serious car accident.

Many times after a car accident, a brain injury is not documented during the acute stage, because physical pain often overrides the awareness of MTBI. Following a concussion or MTBI, awareness levels may be reduced and you may not realize that you have suffered a brain injury. As the body begins to heal and you become more active, the head injury becomes more apparent to you or your loved ones.

Another important fact about mild traumatic brain injuries is that they are cumulative in nature. In other words, if you suffer more than one concussive injury over time, the effects may accumulate and even a small impact to the head, may manifest as a more serious injury. Neurological examinations and brain imaging studies, such as MRI and CT Scans, may be normal even if you have sustained a brain injury. However, your doctor may have ordered these tests in the beginning to rule out other medical conditions.

Newer imaging tests, such as PET Scans or SPECT Scans, have proven to be more informative for this type of injury. The field of neuroimaging is changing rapidly so be sure to consult your doctor to determine which tests would be most beneficial.

Although the injury may be “invisible” to the outside observer, MTBI usually has a number of symptoms, such as nausea, dizziness, vomiting, sleep disturbance, blurred vision, sensitivity to light and sound, fatigue, etc. Emotionally you may feel a shaken sense of self and out of control. Very often there is an overlap of symptoms of Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder (PTSD).

What are some signs and symptoms of a mild traumatic brain injury after a car accident?

In our experience representing head injury victims, the signs and symptoms of a MTBI may be delayed days or weeks in appearing. They may be so subtle as to be missed by family or your doctors. On the outside the victim appears normal. It is inside where the feeling and thought processes are not as they once were. Family and friends, however, may notice a change in personality or behavior before the victim himself or herself does.

Brain injuries cause a constellation or group of symptoms that affect overall functioning. Heightened sensitivity to the environment is a common symptom of MTBI. The following list of symptoms are often associated with MTBI:

Physical symptoms of a mild traumatic brain injury may include:

• Headaches
• Heightened awareness of physical aches and pains
• Nausea, vomiting
• Loss of balance
• Vision problems, blurred vision
• Difficulty reading
• Dizziness
• Loss of sex drive
• Loss of energy
• Easily fatigued
• Sensitivity to light, sound, touch
• Sleep disturbance
• Decrease in senses of smell and taste
• Difficulty with choking and swallowing

Emotional symptoms of a traumatic brain injury may include: 

• Depression
• Mood swings
• Fearfulness
• Apathy, lack of interest, lack of concern
• Low motivation
• Gullibility
• Feeling easily overloaded
• Anxiety, frustration
• Difficulty managing emotions
• Hypervigilance, exaggerated startle response
• Sense of helplessness
• Loss of sense of self, low self-esteem
• Nightmares
• Anger, sudden outbursts
• Mania, excessive excitement  

Cognitive symptoms of a traumatic brain injury may include: 

• Memory loss, forgetting appointments
• Short attention span, easily distracted
• Slowed thinking and longer response time
• Disorientation, confusion
• Brain fatigue, feeling as if in a fog
• Forgetfulness, misplacing things, forgetting previously learned skills
• Difficulty driving, getting lost easily
• Inability to recall words
• Spelling difficulty
• Impaired comprehension, difficulty following conversations
• Difficulty thinking in noisy environments
• Inability to organize thoughts
• Inability to multitask, perform two or three things at once
• Inability to start or finish tasks
• Inability to inhibit certain behaviors—excessive shopping, gambling
• Difficulty with abstract thinking
• Inability to focus on reading, watching TV, computer tasks

No matter where you are in your recovery, if you are experiencing any of the above symptoms, pay attention to the frequency and the intensity of a symptom. How often does it occur? We have seen neuropsychologists we deal with apply the frequency scale of “Never, Sometimes, Frequently, or Almost Always” to symptoms or behavior. For example, do you find yourself missing an appointment, getting confused, or losing your car keys more often than usual? In addition to frequency, it is valuable to be aware of the intensity of a symptom or a behavior.

For example, the intensity of the sound of a person’s voice may be too loud or irritating. Very often, the background noise in a restaurant can be overwhelming and uncomfortable making it difficult to follow the conversations of the people that you may be dining with.

Cognitive and Communication Impairment 

In our experience, many people seem to have trouble thinking clearly following a traumatic brain injury. They sometimes say, “I feel like I am in a fog,” or “It’s like my brain shuts off and the thoughts won’t come.” A clinical term for this type of difficulty is “cognitive communication impairment.” Cognition refers to the mental process of thought, as it relates to awareness, perception, thinking, reasoning and judgment. During the healing period, the brain fatigues rapidly and may shut down. This is called the “camera shutter effect.”

When the brain is rested, the shutter is open. Information comes in easily and can be filtered in terms of what warrants attention. When the brain becomes fatigued because of overload (e.g. too much sound or light, or too much cognitive effort) the shutter will close. You may see people’s lips moving, but not understand what they are saying. You may also feel like your brain is tired and you need to rest. Once your brain is ready, it is important to engage in cognitive rehabilitation. Cognitive therapy has been proven to be very effective in the rehabilitation of thought processes following a brain injury. Such therapy is usually done with a Speech-Language Pathologist or Occupational Therapist who specialize in the treatment of brain injuries.

Physical Pain after a Mild Traumatic Brain Injury

It is normal to experience pain sensations in different parts of the body after a car acciddnt. Pain that originates in one part of the body, but causes pain in a different location is called “referred pain”. For example, a neck injury may refer pain into the head or down into the back. Pain can cause physical hurt as well as mental anguish that may range from mild to severe. Typical words used to describe the pain experience are sharp, dull, aching, burning and throbbing. The mental anguish caused by pain is a significant consequence that can negatively affect the quality of a person’s

The two primary types of pain are: 

• Acute Pain: This pain can be very intense and last for a short time until the injury heals. 

• Chronic Pain: Chronic pain after a car accident is pain that lasts for at least three months and may occur for months or even years. Chronic pain can range from mild to severe.   Chronic pain may disrupt your sleep, as well as your ability to think or perform cognitive/memory tasks. Prolonged pain may cause fear, depression, anxiety and anger.

In Turk and Winter’s book, The Pain Survival Guide, the authors reported many common chronic pain conditions such as back pain, whiplash, fibromyalgia, migraine and tension headaches. Like brain injuries, your pain may be invisible to others, but very real to you. It is important not to overanalyze or question the reality of your pain, even if others infer that you are exaggerating. It is important that you learn to manage your pain and not push beyond your physical limits. You will know when your body and brain are ready for more activity. Pay attention because you are the best judge of our limitations. Take it slow and easy. By being aware of your pain symptoms and developing psychological coping skills to deal with them, it facilitates the recovery process. 

Common pain treatments include: rest, heat, ice, massage, physical therapy, osteopathic work, chiropractic treatments, biofeedback and relaxation, such as breathing exercises and visual imagery, acupuncture, hypnosis, ultrasound, electrical stimulation, changing your activity level, taking medications, injections and surgery. Always talk to your doctor to determine the best treatments for your specific pain symptoms. If you do not get relief, there are doctors who specialize in pain, and there are pain clinics that successfully treat chronic pain – such at the Minerva pain clinic in Hamilton.

Headaches after a mild traumatic brain injury 

Headaches are one of the most common symptoms of mild traumatic brain injuries after a car accident. There are various causes and types of headaches associated with a TBI after a car accident. Trauma to the head or whiplash injuries to the neck may cause posttraumatic headaches and/or muscle tension headaches. Headache pain can be very debilitating and affect your daily functioning. Headaches can affect your ability to interact with your family, do your job, or engage in social and recreational activities. Headaches are normally classified into several types and may range from mild to severe, and may be dull, sharp or throbbing.

After a serious car accident whiplash injury, some people may describe their headache as feeling like a “band around their head.” If you awaken in the morning with a tension headache, it could be related to clenching or grinding your teeth during the night, and it may be prudent to consult with a dentist who specializes in Temporomandibular Joint (TMJ) disorders. Dentists can fit you with a specialized mouth guard to wear at night to protect your teeth and relax the muscles, which in turn, may decrease or stop muscle tension headaches. 

Another type of headache is called posttraumatic migraine headache or a vascular headache. This type of headache may be accompanied by or start with an aura or some type of visual symptom before the headache begins. An aura is usually a visual symptom, such as flashing or sparkling lights, lines in your visual fields, or your vision may be blotted out. Objects may seem farther away  or closer. Some people have reported getting the aura without the migraine pain, which can be referred to as a silent migraine. Other brain-related symptoms may occur, such as numbness on one side of the face or hand, weakness, and unsteadiness. The aura can be used as a signal that you need to lie down and rest, take medications, or use an ice pack on the back of your head or neck to diminish the severity. 

Fatigue after a Mild Traumatic Brain Injury

Many individuals complain of fatigue following traumatic brain injury that may occur only in the beginning phases of recovery or it may last up to several years or more. Typical statements made by patients about fatigue include: “I’m so exhausted I don’t want to get out of bed.” “I feel like I’m in a fog, like I can’t make myself think.” “I’m so tired that I can’t make my brain process information.” Researchers have studied various types of fatigue, including mental or cognitive fatigue, physical fatigue and psychological fatigue. Recent research studies show that fatigue is present in up to 73% of individuals who suffer TBI, and is the first symptom reported by many individuals. (Belmont, A., N. Agar, C. Hugeron, B. Gallals, P. Azouvl. 2008. Fatigue and traumatic brain injury. Ann Readapt Med Phys. 49(6): 283-8.)

Physical fatigue may occur from having to work harder to perform physical tasks, such as cleaning the house or working around the yard. Physical fatigue becomes worse over the day and is usually helped by rest or sleep. Mental or cognitive fatigue may occur when you put forth cognitive effort, such as trying to concentrate, read or solve problems. You may have been able to do these things automatically before your brain injury, but now they may take greater effort, and your accuracy and efficiency may have decreased.

You Don’t Know What You Don’t Know 

When the brain is injured I a car accident, it has to protect itself by shutting out stimuli from the outside world. In other words, the brain shuts down. This may happen many times in an hour or in a day. Sometimes individuals don’t recognize the symptoms of traumatic brain injury, but when they start to recover from their physical injuries, they often say, “I was so injured that I wasn’t aware of what I was doing or saying.” At such times, your awareness levels may be low. It is difficult to know what you are missing until the brain starts to heal and the “cloud lifts.” 

Before an injury, many skills may have come automatically but after the injury, you may have forgotten certain parts of a skill. Previously, you did not have to give full attention to certain activities, such as cooking, reading a book, working on the computer, or driving to familiar places. After a brain injury the “automatic pilot” may or may not be functioning efficiently and your speed of processing can be much slower. Although you think you know how to do a task, you might be surprised to find out that the body is willing but the brain is slower to respond. In other words, “You don’t know what you don’t know.” Don’t be embarrassed or fearful. Rely on people whom you trust as you move through the early stages of healing.

What Are The Long-Term Symptoms and Effects of Traumatic Brain Injury?

In addition to the initial signs and symptoms of brain injury, there are many complications or symptoms that often have ongoing long-term effects well after the recovery period. Depending on the severity of the injury, these symptoms could be permanent and prevent the victim from being able to return to work or perform the activities they previously enjoyed.

Long-term symptoms and complications of a traumatic brain injury commonly include:

• Personality changes or alterations 
• Lack of mobility 
• Cognitive difficulties, including memory loss, difficulty focusing, concentration issues, and/or inability to think 
• Increased risk of chronic traumatic encephalopathy (CTE)
• Early onset dementia or Alzheimer’s disease 
• Mental illness or psychological distress, such as depression, post-traumatic stress disorder, or severe anxiety 
• Chronic migraines 
• Epilepsy 
• Changes in thinking skills or reasoning 

Because these long-term symptoms don’t present immediately, they need to be properly factored into your claim as predicted future outcomes. A good personal injury lawyer will take these complications into consideration or assist you in filing a claim for long-term disability benefits.

Do I need a Brain Injury Lawyer?

If you’ve suffered a mild traumatic brain injury in a car accident, you may need the help of a lawyer who specializes in personal injury law and who deals with and understands MTB’s. It is important to ask the right questions when selecting an brain injury lawyer because you will be working very closely with this person, and you want to have trust in their skills and approach.

When looking for a brain injury lawyer to represent you and your family, some important questions include: 

• Do you specialize in personal injury?
• How long have you practice personal injury law?
• How many other individuals with MTBI have you represented? 
• What has the outcome been? 
• Do you work closely with medical professionals, rehabilitation specialists, vocational rehabilitation experts, and economists who calculate lost income?
• Do you understand the subtleties of MTBI (e.g. visual problems, cognitive problems, hypersensitivity to sound and light, etc.)?
• Do you try cases? 
• How many jury cases have you tried?
• Will I be working with you directly?
• Are you really local?
• Can I visit your office?
• Are you easily accessible?

We would suggest that once you determine the questions that are important to you, you then interview local personal injury lawyers and then choose one who makes you feel comfortable. Remember it’s all about trust and likability.

Also, keep in mind that there are time-sensitive issues in legal cases and you must pay attention to deadlines. A qualified brain injury lawyer can help keep track of these deadlines.

How are legal fees charged in a brain injury case?

We do not charge clients until the end of their case. This is called a contingency fee. At the conclusion of your trial, or at settlement, we charge a percentage, plus any expenses we incur, in the course of handling your case. There is never any money required upfront – at anytime by you. If we decide to work together, our brain injury lawyer will fund your case through to the end.

Have You Suffered a Brain Injury After a Car Accident? Our Hamilton Personal Injury Lawyers Can Help.

We understand that you have just taken a detour on your life’s journey – and that you need help. As important as it is to learn to recognize the signs of a brain injury after a car accident, it’s also vital to make sure you take the right steps to seek compensation as soon as you can to protect your financial future.

Our Hamilton brain injury lawyers can’t reverse the pain and suffering you’re coping with, but we can help guide you through the complicated insurance process, advise you of your legal rights, file all necessary paperwork, look out for your best interests and receive financial compensation that will relieve as much of the financial burden of your recovery as possible.

Since 2003, Matt Lalande has recovered millions of dollars in compensation for traumatic brain injury victims both in and out of the courtroom. We help victims with severe, catastrophic injuries and talking to us is always free. Book a free consultation with us and we’ll go over your options, discuss the details of your case, and give you trusted, reliable, and transparent assistance to help you through this difficult time.

If your in the Hamilton/Burlington/Niagara regions, call us local at 905-333-8888. Otherwise, call us toll-free no matter where you are in Ontario at 1-844-LALANDE (1-844-525-2633) to book your free consultation. You can also request a call back by sending a confidential email through our online contact form.

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LALANDE PERSONAL INJURY LAWYERS  – HAMILTON OFFICE
1 King Street East, Suite 1705
Hamilton, On L8P 1A4
Local: 905-333-8888
Toll Free: 1-844-LALANDE