People generally understand that violent impacts to the head, skull, and neck can result in severe traumatic brain injuries (TBIs). Likewise, people also recognize that a blow to the head that results in a loss of consciousness often signifies that a serious injury has occurred and that emergency treatment should be sought. Similarly, an impact that leave a cut, bruise or other physical injury on the head is also likely to have caused at least a lower-grade brain injury.
However, our understanding of brain injuries is still incomplete, but our knowledge and understanding of the causes of both traumatic injuries and degenerative brain conditions is growing rapidly. Consider that only a few decades ago, few people thought anything of low-grade but repeated blows to the head. Today, due to research involving the donated brains of deceased football players we now know that these frequent impacts play a key role in increasing the risk for the development of chronic traumatic encephalopathy.
A recent article published by NPR further sounds the alarm regarding discounting even a minor bump or bruise to the skull. Especially for at-risk populations, even a slight impact can cause a life-altering brain injury.
NPR’s Recounting of an Internist Who Suffered a Serious Brain Injury Through a Simple Bump to the Head
As reported by NPR, Dr. Bryan Arling is one of the top peer-rated internists in the Washington, D.C. area. However, this story has little to do with Dr. Arling’s practice and begins when he ventured up into his attic to locate a box of files. The doctor searched at length for the files. Then, after locating the box that he was searching for, perhaps in something of an “eureka” moment, he quickly stood up. Seconds after standing, he felt a sharp, shooting pain in the center of his back.
The doctor discounted the sudden pain apparently due to a history of back pain. He attempted to mitigate his symptoms while he allowed his back to heal by taking pain killers. He returned to work, but noticed a number of oddities. At first, it was his strength. The doctor stated that he noticed that he was shuffling while he was walking. He also noticed that he was so weak that he would drop things. Others commented that he “seemed different.”
Eventually Arling came to accept these descriptions as he found that he was still able to do many of the things he did previously — just significantly more slowly. Then, one day, due to particularly intense “back pain” the doctor sought treatment and had an MRI of his back and brain performed.
The scan showed a white pool-like area where the right side of his brain should have been. The shape was a pool of blood that had slowly accumulated inside the doctor’s skull. The pooling blood increased the intracranial pressure and pushed the right-side of his brain out of place.
The white shape was a subdural hematoma. The hematoma occurred during the search in the attic when the doctor stood up suddenly but the bump was so mild and the back pain was so intense that he had forgotten about hitting his head.
What is a Subdural Hematoma?
A subdural hematoma, or acute subdural hematoma, is essentially an internal head injury that causes blood to pool rapidly in the brain. While subdural hematomas can indeed be caused by violent impacts to the skull, they can also be caused by even minor impacts. While the condition is most readily caused by severe impacts, older individuals are particularly at risk of suffering a slow-developing version of the injury caused by only a mild impact. Injuries of this type can unfold over days or weeks and are sometimes referred to as a chronic subdural hematoma.
Elderly individuals are more susceptible to this type of injury due to changes that occur in the brain as an individual ages. The changes to the brain include a deterioration in the protection provided by a vein-filled membrane known as the dura mater. As an individual ages, studies have suggested that the brain begins to contract and move away from the dura. However, the veins inside the dura maintain their connections to both the dura and the brain. As the brain pulls further away, the veins are under greater tension and are more exposed to the forces of an impact. This process seems to be most pronounced in individuals aged 70 years or older.
Seniors and the Elderly Are Most Vulnerable to this Type of Brain Injury
For this population, even the impact of a slight impact can cause a subdural hematoma that develops slowly. According to one research study conducted at 20 percent of U.S. hospitals and published in the Journal of Neurology, 44,000 injuries of this type were diagnosed over a single year. The researchers estimated that, in total, there could be greater than 200,000 incidents of subdural hematomas annually. Thus, there is a possibility that this condition is significantly underdiagnosed by doctors and in hospitals.
However, people should not immediately jump to the conclusion that they have suffered an injury of this type after a bruise or slight trauma. First, injuries of this type are significantly more likely in older individuals. Furthermore, individuals who have hit or jerked their head should also be mindful of their signs and symptoms. A headache alone is usually not enough to sound the alarm, but if the headache is also accompanied by weakness in the extremities or a sudden loss of balance then there may be a cause for concern. Furthermore, like with most head injuries, abrupt changes in thought patterns or a general feeling of oddness may also be observed when an injury of this type is present. If you’re concerned about a brain injury you sustained at the hands of human negligence or an accident involving another person or vehicle, contact the traumatic brain injury lawyers of The Reiff Law Firm or discuss your failure to diagnose lawsuit.