De Caro & Kaplen partner Michael V. Kaplen, a three-term president of the Brain Injury Association of New York State, and professorial lecturer at law, teaching a course in brain injury law at the George Washington University Law School, discusses why brain injury should be classified as a disease.
Why should we classify Traumatic Brain Injury as a Disease Process?
- Brain Injury can last a lifetime. Brain damage is not a singular event or an outcome. It is the beginning of a disease process that can affect multiple organs or systems.
- Medical professionals have recognized traumatic brain injury of any severity as a chronic condition associated with increased risks of cardiovascular, endocrine, neurological, and psychological disorders that may last a lifetime.
What long term risks are associated with a mild traumatic brain injury?
Researchers in Boston found an increased risk of hypertension, diabetes, endocrine disorders, and stroke.
What are the long-term risks and consequences following a traumatic brain injury?
Reduced life expectancy due to the development of long-term neurological conditions and other disorders.
What medical conditions can develop following a traumatic brain injury?
- Seizure Disorders and Epilepsy: Traumatic brain injury is a major cause of epilepsy. Many studies have shown that individuals who sustain the full spectrum of brain injury, from what is initially considered a “mild” brain injury through severe brain injury are more likely than the general population to develop seizures and epilepsy. These seizures may take days, weeks, or even years to develop.
- Parkinson’s Disease: Movement disorders are linked to traumatic brain injury with TBI considered a major risk factor for developing Parkinson’s Disease.
- Vision Disorders: Vision disorders are common after a brain injury. Vision difficulties include visual field deficits, vision loss, blurred or double vision, and difficulty with eye movements, focus, and tracking.
- Sleep Disorders: 70 % of brain injury patients report sleep complaints that may last for years. This includes difficulties falling asleep, staying asleep, or sleeping too long. These sleep disorders impact an individual’s day to day functioning.
- Alzheimer’s Disease: Studies show brain injury is a risk factor for developing Alzheimer’s Disease.
- Chronic Traumatic Encephalopathy: Chronic Traumatic Encephalopathy, commonly called CTE is a distinct pathological finding in the brain caused by repetitive head trauma. Once called “dementia pugilistica” or “punch drunk” because of its association with boxing and boxer’s, it has now been found in the brains of athletes exposed to repetitive head trauma in a variety of sports including football, soccer, and hockey. This condition begins with a deterioration of memory, concentration, and attention and progresses to include gait disturbances, speech impairment and mental health issues including behavior disturbances and suicide.
- Neuroendocrine Disorders: TBI is associated with many neuroendocrine disorders including decreased pituitary functioning known as hypopituitarism resulting in increased fatigue, impaired exercise tolerance and depression. Other neuroendocrine disorders include grown hormone deficiency and impaired functioning of the thyroid gland leading to weight gain and cardiac disorders.
- Urinary Issues: Brain damage has been associated with impaired ability to control bladder functioning resulting in urinary incontinence, the inability to control the flow of urine.
- Psychiatric Disturbances: Mental health issues including psychiatric disturbances such as depression, anxiety, mood disorders, bipolar disorder, suicidal ideations, are strongly associated with a traumatic brain injury.
What other long-term consequences are there following a traumatic brain injury?
- Homelessness
- Domestic Violence
- Substance abuse including drugs and alcohol.
What are the long-term implications of the life lifelong consequences of a traumatic brain injury?
- Developing chronic conditions following a brain injury can complicate the course of recovery, add to the health costs associated with TBI, and impact the quality of life for traumatic brain injury survivors and their families.
- More attention must be given to the chronic effects of traumatic brain injury so better screening, diagnosis, and treatment can be given to brain injury survivors.
- Public health officials and insurance carriers must recognize the long-term consequences of brain trauma and classify traumatic brain injury as a disease entity.
What does The Brain Injury Association of America say about treating brain injury as a disease process?
“Historically, individuals living with a brain injury have been referred to as brain injury survivors. No one knows how that term came to be used in this situation. Perhaps the concept of merely staying alive was used because as little as 30 years age, the majority of individuals with a moderate to severe TBI succumbed soon after heir injury. Perhaps it was used to imply that the individual outlived their injury and persevered despite the hardship of the trauma.”
About The Author
Michael V. Kaplen represents victims of vehicle collisions, unsafe buildings and construction sites, and medical malpractice, and is a preferred attorney of The Brain Injury Association of America.
Michael is board certified as a Civil Trial Advocate and board certified in medical malpractice litigation. He is a Professorial Lecturer in Law, The George Washington University Law School, The Legal Aspects of Traumatic Brain Injury.
Michael is past chairman of the American Association for Justice (AAJ) Automobile, Highway and Premise Liability Section, past chairman of the AAJ Traumatic Brain Injury Litigation Group, three term president of the Brain Injury Association of New York State served two terms as chair of the New York State Traumatic Brain Injury Services Coordinating Council and vice-president, New York State Academy of Trial Lawyers.
He was invited by President Obama to participate in the White House Healthy Kids & Safe Sports Concussion Summit.
He is admitted to courts in New York, Florida, and Washington, DC. He has been selected as a New York Super Lawyer and recognized by Best Lawyers of America and U.S. News and World Report in personal injury law.