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Making Medical Decisions After Suffering a Head Injury

Medical News Today shared information earlier this week on a new research effort from the University of Alabama Birmingham which examined an issue that many fail to consider related to brain injuries. Medical decision-making following the injury is often impaired by the injury iself. This may ultimately lead to a range of complications for those hurt. Our Illinois brain injury lawyers appreciate that this is yet another complication faced by local residents trying to deal with the aftermath of these serious injuries.

The study was published in an issue of the magazine Neurology earlier this month. Part of the research examined the overall connection between brain injury and severity of impairment. Most of the conclusions were obvious and expected. The more severe the traumatic brain injury the more severe the impairment of medical decision-making. In this way, it may actually be the more mild injuries that come with the greatest risks when it comes to medical decision-making. Obviously those who are severely impaired will be recognized right away to be unable to make certain medical decision on their own. Yet, those with more mild injuries may still have trouble making accurate medical decisions. That vulnerability may not necessarily be identified, however, leading to possible harm.

In any event, the research is a reminder both to families and medical professionals of the need to be aware of how a TBI could affect an individual’s ability to make sometimes complex medical decisions in the immediate aftermath of one of these injuries. Choices about rehabilitation programs and treatment for neuropsychiatric problems often must be made immediately after the injury and during the recovery period. Because many TBIs affect decision-making generally, the victim may have trouble making appropriate medical decisions.

This specific research effort involved examination of 86 TBI patients and included use of 40 controls. The TBI group was split into three groups based on the severity of the injury. All participants were then evaluated using standardized measures of medical-decision making ability. That standardized measurement includes analysis of five different areas: appreciation, reasonable choice, expressing choice, reasoning, and understanding.

Those with mild injuries seemed to match up relatively well to the control group on these measures. However the middle group of moderate to severe TBI sufferers performed noticeably worse than the control group on at least three of the five variables. In particular researchers found that the middle group of TBI victims struggled on the variables of understanding, reasoning, and appreciation.

One of the researchers summarized that “This suggest that one month following injury, consent capacity has returned to normal for people with mild TBI, but the structural brain changes characteristic of complicated mild cases may contribute to more significant impairments in decisional capacity that have not resolved 30 days after injury.”

Families and patients dealing with traumatic brain injuries should be aware of these concerns when making decisions about medical care, rehabilitation, and similar issues. There is no quick fix or easy answers when it comes to how to handle these issues but recognizing the possible impairment is a good first step in ensuring it doesn’t affect the injured individual’s recovery.

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