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Traumatic brain injuries have received a great deal more attention in the past few years thanks to high profile sports-related lawsuits centering on traumatic brain injuries sustained as a part of being involved in professional athletic competitions. With the increase in attention, and with new developments in identifying and treating traumatic brain injuries at early stages, medical insurance claims for traumatic brain injury treatments have increased. According to the United States Centers for Disease Control and Prevention (“CDC”), the most recent available data suggests that nearly 2.5 million people sustain traumatic brain injuries on an annual basis in this country. However, in many cases the cost of treating a traumatic brain injury is not confined to an initial visit to an emergency room after the injury has occurred. Individuals with traumatic brain injuries are more likely to require hospitalization after initial treatment, which has a huge impact on the cost of treating such injuries. The CDC says traumatic brain injuries are also a contributing factor for around 30 percent of all injury-related deaths in the United States, making prolonged treatment and hospitalization crucial in ensuring a person’s successful recovery in many situations.

Cost of Treatment

The true cost of treating a traumatic brain injury can be hard to establish and depends greatly on the individual victim’s circumstances. Not only are mounting medical bills a concern, but the injury may also require significant financial sacrifices from family members. Costs to treat traumatic brain injuries may reach well into the hundreds of thousands of dollars for an individual victim, especially in circumstances where rehabilitation or continued medical care is required. In many cases, victims may not have insurance or may not have adequate enough insurance coverage to pay for required treatment and follow-up medical care. Sometimes, a caregiver needs to take an extended leave from work in order to help meet a victim’s needs, which further drains a family’s financial resources.

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Some of the immediate effects of traumatic brain injuries are noticeable once a victim has sustained such an injury. Severe brain injuries cause loss of consciousness and coma, which are generally graded using the Glasgow Coma Scale to establish the severity of the brain injury. Short-term side effects of such injuries can include short-term hospitalization and rehabilitation. These short-term consequences are the result of side effects that doctors can observe through extensive medical testing shortly after the injury occurs and in the weeks following the injury.

However, while new research may allow medical professionals to better diagnose traumatic brain injuries and predict their immediate consequences, it is still extremely difficult to anticipate the long-term side effects of traumatic brain injuries. Many of the long-term side effects do not manifest until weeks, months, years, or even decades after an injury has occurred. Unfortunately, medical science has little research to allow medical professionals to accurately predict how a traumatic brain injury will affect a specific individual. However, research ahs shown some of the more common effects that traumatic brain injuries – especially repeated injuries – can have on victims. It is important to keep these potential long-term side effects in mind when planning for a victim’s care, or when pursuing compensation from someone that caused such an injury. Brainline.org provides some information on the potential long-term side effects of moderate or severe traumatic brain injuries so that families and victims can plan accordingly.

Anticipating Long-Term Effects

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A great deal of attention has recently been given to the importance of proper treatment of traumatic brain injury to help prevent further complications after the injury has occurred. Many times, traumatic brain injuries have lasting effects that cannot be predicted immediately after the injury, and some of the repercussions of these injuries are not seen for months or years after the injury has occurred. However, another concern related to traumatic brain injuries is the chance of death associated with them. According to Medscape, recent research published in The New England Journal of Medicine has shown that decompressive surgery may decrease the risk of death caused by traumatic brain injury. The average age of participants in the study was 33, and most had sustained their injuries through severe falls, assaults, or vehicle accidents.

What does the research suggest?

Decompressive surgery, the medical term for which is decompressive craniectomy, is the removal of a large section of the skull after a traumatic brain injury has occurred to allow the brain to expand from swelling after an injury. In a study that randomly selected hundreds of patients from different hospitals throughout the world, known as the Randomised Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of Intracranial Pressure, a decrease in deaths related to traumatic brain injury that caused brain swelling was noted. The study spanned several years and found that victims of traumatic brain injuries causing severe swelling from incidents such as severe falls or vehicle accidents who underwent decompressive surgery had a fatality rate of 26.9 percent compared to the control group’s fatality rate of 48.9 percent. Members of the control group did not undergo decompressive surgery.

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According to a recent article from Medscape, U.S. Army investigators report that a quick and simple test performed with a pupillometer may be an effective way to test for the presence of a concussion and traumatic brain injury. A pupillometer is a tool that measures pupillary distance, and a new study has demonstrated that using this tool may provide medical professionals with new clues as to the existence of a traumatic brain injury and concussion. According to the report, using this tool may help medical professionals identify functional differences in pupillary distance that can be used to create a set of identifiable parameters that medical professionals can use to search for the presence of traumatic brain injuries. The initial testing that has led investigators to believe they may on the verge of identifying another useful tool in diagnosing traumatic brain injuries used dim lighting conditions to measure pupillary dilation, reaction time, and how long it took pupils to return to normal after using a light source as a stimulus. Basing findings against a control group with no history of traumatic brain injuries, investigators believe they have begun to identify markers that will help medical professionals quickly and accurately identify the presence of a traumatic brain injury that may have otherwise gone undetected.
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Several dozen well-known wrestlers that have worked for a well-known wrestling company have joined in a class-action suit against that company, according to the Chicago Tribune. The lawsuit alleges that the plaintiffs incurred “long term neurological injuries” as a direct result of working for the company because the company allegedly “routinely failed to care” for them “in any medically competent or meaningful manner.” The lawsuit also alleges that the company “fraudulently misrepresented and concealed” the nature of injuries sustained in the course of employment. The lawsuit has the potential to become another high profile legal action dealing with professional athletes that have allegedly sustained long-term brain injuries, and further highlights the risks associated with repeated traumatic brain injuries.

Like other lawsuits filed by groups of professional athletes, this new lawsuit alleges that repeated traumatic brain injuries have resulted in the development of Chronic Traumatic Encephalopathy (“CTE”). CTE is a progressive form of a degenerative brain disease that is found in people, mostly athletes, that have a history of recurring brain trauma including concussions and asymptomatic subconcussive blows to the head. This degeneration can cause memory loss, confusion, impaired judgment, issues with impulse control, depression, aggression, and eventually progressive dementia. Symptoms can start in as little as a few months after the athletic involvement, or may not appear until decades later.

Legal Obstacles
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A recent settlement between the State of Maryland and the National Collegiate Athletic Association (“NCAA”) may change the way college sports injuries are addressed. An article in The Baltimore Sun discussed the settlement, noting that while the payment to the victim’s family is relatively small, it could have far-reaching implications for other injuries and similar lawsuits across the country. The article explains that the State of Maryland became involved in the lawsuit because the victim’s family’s initial million-dollar claim named three state employees working in athletic capacities at a state university as among the defendants in the lawsuit.

Allegations

The case centers around preseason drills that took place during a practice in 2011. According to the allegations in the lawsuit, players had been forced to complete a series of physically difficult practice drills, allegedly including running into each other helmet first even though regulations are supposed to prohibit such practices. Additionally, the lawsuit alleged that the state employees discouraged players from reporting injuries sustained during drills and practices, often ridiculing players that would choose to report such injuries anyhow.
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A new study from the American College of Surgeons has indicated that administering blood thinning medications within 72 hours of a victim sustaining a traumatic brain injury can reduce the potential likelihood of life-threatening blood clots without increased risk of bleeding complications or death in patients. According to the article linked above detailing some findings of the new study, one in five patients being treated at trauma centers for serious injury are victims of a traumatic brain injury. The study’s author indicated that there had previously been no evidence detailing the time frame in which the administration of blood thinning medication could prove to help patients avoid blood clots.

Data Collection and Results

The data for the new study was collected by studying patients already observed in the American College of Surgeons’ Trauma Quality Improvement Program between 2012 and 2014. The study’s goal was to measure the success of administering blood thinning medications in the early stages of treatment versus the later stages of treatment with a focus on the occurrence of deep vein thrombosis and pulmonary embolism. Over 3,000 adults with traumatic brain injury were ultimately studied after having been broken into two groups: those that received blood thinning medications in the early stages of treatment and those that received blood thinning medications in later stages of treatment.
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Head injuries incurred from sports-related activities are on of the fastest growing health insurance claims, according to a recent report from CNBC. The report notes that recent high-profile sports-related lawsuits over brain injuries sustained as a result of engaging in various athletic activities have highlighted the severity of such injuries, and have encouraged more people to report them and seek appropriate medical treatment. Two of the most notable cases that have received extensive media coverage include a class-action settlement last year between the National Football League and thousands of former players from that league as well as a more recent class-action lawsuit filed by more than 50 former professional wrestlers against a major wrestling entertainment company.

The momentum that both of these cases have achieved may be a catalyst in encouraging other professional and amateur players engaged in sports where they wear protective headgear to follow suit and seek compensation from entities such as athletic leagues, schools, helmet manufacturers, and retailers that sell safety equipment.

Basis of Legal Claims

Standard & Poor’s, an international company that provides credit ratings and market insight based on research, was the author of the information used in the article. It paints similarities between sports-related neurological claims and asbestos-related claims, both in the United States and the United Kingdom. Specifically, both injuries sustained as a result of an activity are latent injuries. This means they could take weeks, months, years, or even decades to manifest after an incident that may trigger them.

It is often difficult in both cases to assert a successful initial claim that is comprehensive enough to cover potential damages sustained as a result of related activities, which is why it may have taken so long for former professional football players and retired wrestlers to realize the full effect brain injuries may have had on them. As a result, Standard & Poor’s notes that many insurance companies are actually capping payouts on concussion lawsuits and including exclusion clauses in policies for concussion-related injuries.

While each legal action is unique, recent actions concerning sports-related head injuries have primarily focused on professional athletic groups’ negligence in informing members of the potential severity of such injuries. In other words, many lawsuits attempt to demonstrate that the agency charged with governing a certain sport or group of athletes was aware of the potential risk of such injuries but did not inform players, did not enact measures to prevent such injuries, and/or allowed activities that could cause such injuries to continue.
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According to a recap published on Medscape that discussed the results of a recent study, traumatic brain injuries are not associated with the development of Alzheimer’s Disease later in life but are instead linked to the development of Parkinson’s Disease later in life. The new study suggests that traumatic brain injuries can be linked to the accumulation of Lewy bodies, which are associated with Lewy Body Dementia and Parkinson’s Disease according to the National Institutes of Health’s National Institute on Aging. Lewy bodies are abnormal protein deposits in the brain that can affect certain chemical levels in the brain, which can eventually lead to problems with thinking, movement, behavior, and mood. Ultimately, these affect a person’s ability to function normally on a day-to-day basis and may lead to Parkinson’s Disease or Lewy Body Dementia.

The study, published this month, contradicts an influential study from 1995 that had previously linked some aspects of traumatic brain injury with Alzheimer’s Disease. According to the lead author of the new study, the researchers had set out to prove the link between traumatic brain injuries and Alzheimer’s Disease later in life. According to the article, they instead found that a single blow to the head that resulted in the victim losing consciousness for more than one hour increased the risk of developing Parkinson’s Disease later in life by three-fold. The new study used data collected from three other studies that included participants initially free from dementia. The participants in the three other studies included older Seattle-area Group Health members; older religious clergy from across the United States; and older residents from the Chicago-area enrolled in the study through retirement facilities, subsidized housing, church groups, and social services. Having included thousands of older adults in the three studies used to conduct the study at hand, no particular link was found between the occurrence of traumatic brain injuries with loss of consciousness over one hour and Alzheimer’s Disease. Researchers indicated that they found a “pretty strong” association between loss of consciousness lasting more than an hour and the risk of developing Lewy bodies based on comprehensive neuropathic evaluations conducted at the time of death. The research indicated an average 40-year gap between a traumatic brain injury with loss of consciousness over one hours and the development of microscopic evidence of abnormal proteins associated with Lewy bodies.
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Almost every time that someone gets hit in the head, either by an object or another person, there is some type of injury that occurs. With just a slight bump, perhaps caused by hitting the temple of your head against an open cupboard, there will likely be a cut followed by some swelling and a bruise. In other cases of more severe head trauma, a person may be rendered unconscious by being hit in the head. In these cases, a person will likely face some swelling, bruising, and a concussion. A concussion is a term that means temporary unconsciousness caused by a blow to the head, but it is often used to describe the period of time after the concussion in which medical care and observation is needed.

However, while many people believe these types of injuries to be minor, they may actually be very serious traumatic brain injuries. Concussions that are shorter in length, usually under 20-30 minutes, can also be classified as mild traumatic brain injuries. From that point, there are moderate and severe brain injuries. Generally, a person suffering a concussion is observed for a period of time and then given a clean bill of health. Sometimes CAT scans or MRIs are involved in ensuring that no additional damage has been done, depending on the severity of the injury. However, sometimes serious traumatic brain injuries resulting from what appear to be mild concussions are misdiagnosed. When this happens, a person is at increased risk of prolonged neurological damage that may have a profound effect on that person’s well-being and ability to thrive as a human being. Some symptoms of traumatic brain injury that are often overlooked are discussed below.

Symptoms of Mild Traumatic Brain Injury

When a person is taken to the hospital after a bump on the head, especially after loss of consciousness, it is not uncommon for medical providers to perform CAT scans and MRIs to determine the extent of any damage that may have been done to the brain
. Often times, such tests may show that no visible damage has occurred. However, some signs and symptoms that minor traumatic brain injury has in fact occurred include but are not limited to:

· Fatigue;
· Headaches;
· Memory loss;
· Sleep disturbances;
· Feelings of depression;
· Loss of sense of smell;
· Nausea;
· Confusion; and
· Seizures.
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