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Why MRIs and CT Scans Often Miss Traumatic Brain Injuries

Atlanta personal injury lawyerWe've covered the types, symptoms, and treatments for traumatic brain injuries after a wreck or work accident in a previous blog post. Sometimes the signs are obvious, but many times they are not.

Here's how to find out if you're suffering from a traumatic brain injury (TBI) caused by a wreck or work accident and why it's so important to have an accurate diagnosis.

Only a doctor can identify the extent of your injuries. Brain injuries can alter cognition, behavior, vision, hormones, speech, sleep, blood flow, internal organs, nervous system, and many other bodily functions.

Left untreated, a TBI can lead to neurodegeneration, making it much more likely to develop diseases like Alzheimer's or Parkinson's later in life.

Other traumatic brain injuries come with secondary injuries like brainstem issues, inner ear problems, PTSD, and depression.

Getting down these symptoms and diagnosing a TBI is crucial for a personal injury case if you want a fair outcome and settlement. The longer you wait or the more you downplay symptoms, the easier it is for the insurance company to reduce or deny a claim.

Diagnosing brain injuries, however, can be complicated. About 80 percent of TBIs cannot be seen on an MRI or CT scan. The only other way to discover a TBI used to be neuropsychological or psychological testing - a fancy way of saying doctors ask patients questions or give them tasks to complete.

The good news is there are more advanced brain imaging scanners available if an MRI or CT scan cannot find brain damage. Advanced neuroimaging techniques include fMRI, MR spectroscopy, Diffusion Weight imaging (DWI), Diffusion Tensor Imaging (DTI) / Diffusion Kurtosis Imaging (DKI), perfusion imaging, PET/SPECT, and magnetoencephalography (MEG).

If an MRI or CT scan comes up negative for a TBI but you know something isn't right, talk to your doctor about other neuroimaging options and tests.

Mild Traumatic Brain Injuries

About 75 percent of TBIs are classified as "mild." The American Congress of Rehabilitation Medicine defines a mild TBI in "as a traumatically-induced physiological disruption of brain function" as evidenced by:

  1. temporary loss of consciousness (30 minutes or less);
  2. any loss of memory immediately before or after the accident; and
  3. an altered mental state at the time of the accident (feeling dazed, disoriented or confused).

Brain injuries do not always have obvious or outwardly visible signs. Cognitive, psychological, and/or behavioral changes or impairments can go undiagnosed if ignored or misunderstood.

While 80-90 percent of injured victims recover after about three months, 10-20 percent of people who've suffered a mild concussion deal with persistent symptoms.

How MRI and CT Scans Work and Their Limitations

MRI and CT scans function best at identifying macroscopic (large) lesions. Although it's improving, the technologies are often unable to pinpoint microscopic injuries to neurons and neural connections often associated with mild brain injuries.

A computerized tomography (CT) scan takes a series of X-rays images of different angles around your body, which is then processed and compiled by a computer into a single picture. Unlike an X-ray, CT scans provide more detailed information about your bones, blood vessels, and soft tissues. After a wreck or injury, a doctor may order a CT scan because it is a quick way to see if there is any obvious internal trauma.

A Magnetic Resonance Imaging (MRI) machine uses strong magnetic fields and radio waves to create detailed images of the organs and tissues within the body. MRIs are non-invasive and create amazingly detailed images of internal tissues, even more so than a CT scan. But if a person has metal inside their body from shrapnel or medical device, or is afraid of enclosed spaces, an MRI cannot be used.

CT scans and MRIs are wonderful tools to diagnose injuries but they don't always catch every injury. There are a few reasons for this:

  • CT scans often miss soft tissue injuries and other abnormalities. An MRI may or may not detect these.
  • Some TBIs can take time to develop. A microscopic brain bleed or nerve fiber damage might not occur for hours or even days, long after you've visited the emergency room.
  • The radiologist interpreting it the imaging scans may not have access to the latest technology or experience necessary to identify your injury. If your scan was performed on an older machine or your physician did not request special contrast dye, your MRI or CT scan might not reveal the true extent of the damage.

Doctors and insurance companies often rely on the radiologist's interpretation of the scan. Most radiologists are trained professionals who do their best to accurately read MRI and CT results, but mistakes can and do occur if a radiologist does not have access to your list of symptoms and cause of injury. They lack the full picture to put your scans into context.

You may still have a valid personal injury claim, even if your diagnostic tests for a brain injury came back "normal." A TBI isn't determined solely by a scan. An accurate diagnosis consists of the facts surrounding the accident, reported symptoms, and physical and neuropsychological exams.

Unfortunately, insurance companies frequently use a "normal" MRI or CT scan to deny personal injury or workers' compensation claims. This is because TBI claims are expensive. Many brain injury victims need surgery, physical therapy, occupational therapy, and other intensive treatment.

To cut costs, insurance companies will look for any reason to dispute your head injury claim. If you believe your traumatic brain injury claim is being wrongly ignored or denied, you should immediately contact our personal injury law firm to handle your TBI case.

Gary Martin Hays & Associates: Helping Brain Injury Victims

Normal MRIs and CT scans can fail to find evidence of a large majority of brain damage. While you may feel confused or helpless at first, the important thing is to not give up. It's vital you receive a correct brain injury diagnosis so that you can receive all the medical treatment, rehabilitation, and compensation you need to recover.

Whether your injury happened at work, because of an assault, or during a car or motorcycle accident, our attorneys and case managers can help you find the right doctors to help treat your brain injury.

If you have questions about traumatic brain injuries and your legal rights after a wreck or work injury, contact us online or at (770) 934-8000 for a free evaluation of your case.


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