Often, the lawyer does not understand his/her role in assisting the client in receiving the specialized healthcare needed to diagnose and treat the client’s injuries. Car wrecks often cause “soft tissue” injuries without the breaking of bones and joints. Many of these car wrecks cause damage to the brain, but the client is never told by their lawyer that these injuries, even though subtle, can cause a lifetime of misery and suffering.
Many people who have experienced “whiplash” injuries in rear-end crashes don’t understand that you don’t have to lose consciousness to suffer a lifelong Traumatic Brain Injury (TBI). When most people think of concussions, they think of someone being knocked “out cold.” But as the Mayo Clinic reports, being dazed, confused or disoriented without a loss of consciousness is a symptom of a mild traumatic brain injury (mTBI), and symptoms may appear immediately or days or weeks later. Just one concussion without loss of consciousness significantly increases the risk of developing Alzheimer’s and Parkinson’s disease. A 2018 study found that even a mild TBI increases the risk for Parkinson’s disease by 56%, and that risk increases to 83% if it was a moderate to severe TBI. The risk of developing Alzheimer’s disease and dementia also increases; a 2021 study found that “a single prior head injury was associated with a 1.25 times increased risk of dementia, and a history of two or more prior head injuries was associated with over 2 times increased risk of dementia compared to individuals without a history of head injury.”
In the past, one of the only tools for diagnosing “post-concussion syndrome” or mTBI required the doctor to see if a patient could follow his/her finger moving in the patient’s field of vision. This test was used to diagnose vertigo. Vertigo is often the primary disabling symptom of a whiplash injury, and vertigo can last a lifetime.
Nowadays, doctors have much more detailed diagnostic information to diagnose vertigo of “central origin” (an injury to the brain stem caused by whiplash) thanks to Vestibulonystagmography (VNG). For an in-depth discussion of the efficacy and scientific underpinnings of VNG, see the TED Talk on the subject given by Uzma Samadini, a PhD, neurosurgeon, and Chairman of the New York Harbor Health Care System, as well as NYU professor of medicine.
VNG is the gold standard for the diagnosis of injury to the vestibular system (vertigo of central origin), a continuum of the brainstem that includes the nerve structures of the inner ear. The vestibular system is not a system that operates independently of the brain; just as paralysis in an extremity indicates injury to the spinal cord, dysfunction of the vestibular system indicates injury to the brain and helps to identify the location and extent of the injury. The diagram below demonstrates the vestibular system’s physical proximity to the brain.
Using camera eye-tracking technology, VNG systems detect deficits in oculomotor coordination, which are hallmarks of a vertigo-related brain injury, by recording the movement of the eye as it attempts to follow a computer-generated stimulus. Meta-analysis research published in Nature, one of the most respected scientific journals in the world, summarizes the connection between an mTBI and the ability of patients to track external stimuli using VNG techniques. Even subtle impairments to the central nervous system caused by an mTBI produce abnormal movement control patterns, eye-tracking ability, and reaction to environmental stimuli.
Difficulty with balance after a car wreck is a hallmark sign of a vestibular injury. If you have been in a car crash and suffer difficulty with balance, memory deficits, difficulty with sleep (either trouble sleeping or sleeping too much), irritability, headaches, dizziness, sensitivity to light or sound, mood changes or mood swings, or trouble concentrating, it is important that you be evaluated by a neurologist or neurosurgeon who is experienced in diagnosing and treating post-concussion syndrome and mTBIs.
Just this year, the NFL has instituted new rules: if a player is diagnosed with “ataxia” (loss of balance- an inability to coordinate voluntary muscular movement that is symptomatic of vertigo of central origin) by any club or neutral physician involved in the application of the NFL Concussion Protocol, he will be prohibited from returning to the game, and will receive the follow-up care required by the Protocol. The NFL’s attention to this symptom alone is a strong indicator that car accident victims and their lawyers should be sensitive to vestibular injuries in whiplash cases as well.
A whiplash injury is not just about your neck/spine, but more about the indication that you have suffered a brain injury. If you have been in a car wreck, insist that you be seen by a qualified physician. Just like not all lawyers have the same skills, neither do all doctors have the same skills. Seeing a doctor who specializes in these types of injuries is imperative for anyone who has been in a car wreck, and will help your lawyer get the full value of your case.