A Practical Guide to Evaluating Your Concussion

If you or a loved one has been diagnosed with a mild traumatic brain injury (mTBI) or more commonly known as concussion, and another party is at fault for causing the injury, you or your loved one may have a compensation claim for the injury. The fact that the injury is categorized as “mild” on the traumatic brain injury spectrum does not determine the level of compensation.

The Centers for Disease Control and Prevention (CDC) defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. Everyone is at risk for a TBI, with risks rising for certain age groups, like children and older adults, and activities like contact sports and road bicycling. TBIs are categorized into a range from mild to moderate to severe. These categories are based upon changes in mental state or consciousness at the time of the injury. A mild traumatic brain injury (mTBI) is characterized by a brief change in mental status or consciousness or no loss of consciousness at all. A mTBI is commonly called a concussion. Most TBIs that occur each year are mTBIs. The term “mild” does not mean that a mTBI is unimportant or a minor injury; certainly, to a person who has suffered a brain injury, the term “mild” is misleading and a misnomer. A diagnosis of concussion indicates a sudden neurophysiological event as a result of blunt impact to the head, neck, or body (with transmitting forces to the brain), such as from sudden acceleration, deceleration, or rotational forces (which are especially damaging). Concussions are commonly sustained in a motor vehicle or bicycle crash, sports injury, and falls.

The symptoms of concussion vary widely. Just as each person is unique, each concussion is unique. Concussion symptoms vary in type, number, duration, and intensity. Treatments and management of concussions are often vague. Outcomes are often difficult to predict. In an attempt to classify the severity of a concussion and provide better treatment, management, and prognosis, a grading scale for concussions was developed. Concussions are graded based upon level of severity and the grading scale largely depends on the length of loss of consciousness or LOC at the time of injury. There are three grades of concussion: 1, 2, and 3. Grade 1 is a concussion where the person experiences transient (lasting a short time) confusion but does not lose consciousness. Symptoms typically resolve in less than 15 minutes. Patients with Grade 2 concussions also experience transient confusion and remain conscious, but the signs and symptoms last longer than 15 minutes.A Grade 3 concussion indicates LOC regardless of how long it lasts.

The symptoms that may follow mTBI typically fall into four categories - physical (like headaches, migraines, dizziness, blurry vision, and sensitivity to sound and light), cognitive (like memory problems, lack of concentration, disorientation, mental fogginess, problems finding words and expressing yourself, and forgetfulness), emotional (like anxiety, depression, irritability, aggression, excessive crying, and acting out), and sleep (like sleep disturbances, changes in sleep pattern, insomnia, and fatigue). Patients typically experience one or more symptoms from one or more categories. While each symptom is concerning, some of the most frustrating and disruptive symptoms of concussion are the impact on sleep and sleep patterns.

Sleep disturbance is a very real and common complaint in patients after mTBI. The term “sleep disturbance” covers a broad range of disorders. Common among people suffering mTBI are increased sleep need, excessive daytime sleepiness (dozing off), and poor sleep quality which includes difficulty falling asleep (sleep onset insomnia), difficulty staying asleep (maintenance insomnia), and unwanted early morning awakening (terminal insomnia). Daytime fatigue is also common and typically defined as a feeling of extreme tiredness accompanied by a feeling of weakness, weariness, or distress. Studies have shown that sleep disturbances and fatigue that can last a full year after a concussion and sleep disturbances and fatigue are associated with a host of adverse consequences including reduced cognitive function, emotional distress, and overall reduction in quality of life.

The more commonly reported sleep disturbances after concussion are insomnia (poor sleep quality) and hypersomnolence disorder (excessive sleep quantity and daytime sleepiness). These are often accompanied by daytime distress, worry, or fatigue. Other common sleep issues reported by people who have suffered a mTBI are difficulty falling asleep, difficulty staying asleep, difficulty staying awake during the day (dozing off), feeling tired and unrefreshed upon awakening, increased sleep need, unwanted early morning awakening, nightmares, restless sleep (tossing and turning), requiring daily/multiple naps, significant daytime impairment, and requiring a sleep aid (sleeping pill, alcohol, or anti-anxiety medication).

Concussion is a traumatic brain injury at the beginning of the brain injury spectrum ranging from mild to moderate to severe brain injury. Concussions are further classified into grades. If your concussion was the result of an accident where some other person or entity was a fault, remember the classification and rating system for a concussion does not determine your compensation. These systems were meant to be used by healthcare professionals to provide a more uniform diagnostic tool, select appropriate treatments and management, and aid in prognosis or the predicted course or outcome of the injury.

Jim Dodson
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A Florida injury lawyer, family man and avid cyclist who clients have trusted for over 25 years.