Proving Traumatic Brain Injury in Court

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Video Transcript

Using Medical Imaging to Prove Traumatic Brain Injury in Court

Michael V. Kaplen: As brain injury attorneys, we are often called upon in court to show the jury if we can, the portion of our client’s brain that was damaged.

Many difficulties arise, because while most brain images are able to show bleeding in the brain and fractures to the skull, the most common types of brain imaging studies, namely CT scans and MRI scans fail to detect the microscopic and chemical changes that take place in the brain following brain trauma and a concussion.

It is important for brain injury attorneys to understand that standard brain imaging techniques, CT Scans and MRI studies are not tests that show how the brain is functioning. It is only a picture of the brain and is not sensitive enough to show the brain damage that has taken place.

In fact, CT scans and MRI scans, can’t even tell if the patient is awake or asleep, or even if the patient is alive or dead.

It is important for those who represent brain injury survivors to know that these imaging studies are not detailed enough to provide evidence of brain injury because of the limits of technology.

As is often said in medicine, Absence of proof, is not absence of injury

Important new brain imaging techniques now provide assistance to attorneys to prove that their client did sustain a traumatic brain injury. The new tests show how the brain is functioning rather than how it looks.

One such technique are newer and more powerful MRI machines known as TESLA 3 MRI studies. These machines are twice as powerful as the version in use in most hospitals today. This new and more powerful MRI machine is able to detect structural damage that previously could not be seen.

Importantly it can also detect something known as hemosidron deposits, which are iron deposits following the tearing of microscopic blood vessels. The tearing of these blood vessels is evidence that the brain itself was injured.

Other important brain imaging studies allow us to see how the brain is functioning. One such study is called a PET scan and allows physicians to see how the brain is using oxygen. Oxygen is the energy food for the brain.

As the brain works harder, it needs more oxygen.

In colored pictures of the brain, we are able to see those areas of the brain that are not receiving sufficient amounts of oxygen because of damage to brain cells.

Diffusion Tensor MRI studies also show how the brain is functioning.
This study allows us to see how water molecules flow through brain nerve fibers. When these nerve fibers are damaged as a result of trauma, the water does not flow evenly which can be seen in an image that is created on the computer.

Finally, functional MRI studies also show which areas of the brain are functioning properly when the patient is asked to perform different tasks involving thinking.

Any lawyer handling a traumatic brain injury case needs to know about the availability of these new generation of brain injury studies and how to properly utilize them in the presentation of a brain injury case to objectively show their client’s brain damage in a courtroom.