Minor Traumatic Brain Injury (MTBI) – What You Need to Know
Even a Mild Head Injury Has the Potential to Be Serious
MTBI (Minor Traumatic Brain Injury) can occur in whiplash type accidents and the human skull does not need to sustain a blunt trauma impact in order to sustain a MTBI.
According to Parker and Rosenblum (Parker RS, Rosenblum A. “IQ loss and emotional dysfunctions after mild head injury incurred in a motor vehicle accident.” Journal of Clinical Psychology 1996; 52(1):32-43.) provide a thorough summary of the causes of MTBI:
“MTBI needs only sufficient angular rotation (without impact) to occur, although unreported head impact in MVA is common. Rear-end impact causes the head on the relaxed neck to be left behind momentarily. Front-end collision causes the head to be propelled forward. The head moves in a combination of planes (lateral and sagittal) and torsion around the tethering neck, which changes the brain’s position and movement relative to the enclosing skull and often causes impact within the confining space. It is unpredictable which structures will be over-stressed and damaged. MTBI is determined by: the point of impact and its direction, velocity, and accelerating or decelerating effect; whether the neck is braced; whether the rotation is accelerated or steady; the relative strength of the head-neck junction; ratio of brain mass to head mass; duration of the impact impulse; and characteristics of the scalp. Intensive head movement causes contusions of the frontal and temporal poles from translational motion, most severe at the crests of gyri, but which can extend subcortically. Lacerations occur of the base of the brain from lateral or angular motion. Rotation in the coronal plane causes shearing of internal structures and penetrating blood vessels and tensile and compression strains. Head impact causes skull and brain deformation; energy directed inwardly coup, contre-coup and/or diffuse brain injury, and pressure gradients.”
Friedmann et al (Friedmann LW, Marin EL, Padula PA. Biomechanics of cervical trauma, in Painful Cervical Trauma: Diagnosis and Rehabilitative Treatment of Neuromuscular Injuries, ed. Tollison CD, Satterthwaite JR. 1992; 10-19.) wrote, “Patients receiving whiplash injury of the neck can also suffer from a cerebral concussion. Mechanical deformation of the brain occurs during the acceleration/deceleration phase of the injury and a concussion can occur without the head actually striking anything.”
In Teasell and McCain (Teasell RW, McCain GA. “Clinical spectrum and management of whiplash injuries.” Painful Cervical Trauma: Diagnosis and Rehabilitative Treatment of Neuromuscular Injuries, ed. Tollison CD, Satterthwaite JR. 1992; 292-318.) elaborate: “It has been proposed that rotational brain shear injuries occur as a result of sudden movement of the skull, especially sudden angular acceleration, resulting in surface trauma to the cerebral cortex and cerebellum. This theory posits that the brain lies relatively free within the skull. As the head moves, the brain, because of its inertia, tends to maintain its position within the vault. The moving skull may therefore concuss the brain either as it rotates backward or as it accelerates forward.”
Minor Traumatic Brain Injury Study
This study evaluated the effects of minor traumatic brain injury (MTBI) in whiplash patients an average of 20 months after their accidents.
There were 33 subjects involved in this study, and all had suffered automobile whiplash injuries. Those excluded from the study were those with “inpatient treatment, unconsciousness for more than 5 minutes, skull fracture, cerebral hemorrhage, contusions, or lacerations.”
The authors first estimated baseline IQ levels from age and level of education, and from the fact that mild TBI does not seem to affect Verbal IQ levels, but only Performance IQ. Each patient was then tested for current IQ level. The researchers found a mean loss of 14 points of Full Scale IQ.
The study also found a wide variety of psychiatric disturbances related to whiplash. These included Post-Traumatic Stress Disorder, sexual dysfunction, resentment and anger, depression, and altered consciousness.
The study concludes:
“The findings support other research that has demonstrated that apparently minor impact and acceleration injuries of the head can cause significant interacting intellectual and emotional dysfunctions.”
All patients should be carefully examined for signs of head impact after whiplash. Many patients in this study did not report head impact at the time of injury because of the stress and confusion of the accident or due to TBI.
A wide range of functions should be evaluated in these patients, including: “consciousness, sensorimotor, neurophysiological, cerebral personality disorders, general intelligence, memory, language, information processing, post-traumatic stress, identity, adaptation, and developmental problems of children.”
Parker RS, Rosenblum A. “IQ loss and emotional dysfunctions after mild head injury incurred in a motor vehicle accident.” Journal of Clinical Psychology 1996; 52(1):32-43.
Have You Suffered a Mild TBI? Call our Brockton Truck Accident Attorneys for a Free Legal Consultation
If you sustained a head injury in an accident involving a motor vehicle, or from any other type of accident that was not your fault, you may be entitled to compensation for your injuries, or for the loss of a loved on killed in a fatal accident.
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