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The standard response from insurance companies who defend TBIs is that there is “no objective evidence” of a TBI. What insurance companies, and most lawyers who handle TBIs do not know, is that traditional radiography, i.e. MRI and CT, are not sensitive enough to pick up brain damage in majority of accidents. Therefore, if MRI or CT are the only tools being used to diagnose or evaluate TBI, then majority of the time a TBI will be missed.
While MRI and CT are very useful tools in the emergency room because they can quickly rule out active bleeding and damage to the brain’s structure (skull, position within the skull, etc.), studies have shown that less than 10% of TBIs are revealed on CT. This is because the majority of TBIs are caused by axonal injury. Axons are the connecting fibers in the brain, which during a TBI are sheared due to the rapid shifting of the brain inside the skull. MRI and CT are not sensitive enough to reveal this type of injury, which is the root problem when using those tools to diagnose a TBI.
The good news is that newer imaging techniques have become more widely used to diagnose TBIs. The most common of these newer techniques is Diffusion Tensor Imaging (DTI). DTI looks for white matter changes, which is the best indication of axonal injury. DTI uses advanced software to overlay on top of an MRI to get more detailed information/images of white matter.
Other available technology includes Single-Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET). SPECT is a valuable tool in diagnosing TBI because it reveals cerebral blood flow and therefore can identify parts of the brain that are either not working, working properly, or working too hard. A PET scan, commonly used to diagnose cancer, uses a radioactive substance called a Tracer to look for disease or injury in the brain. Whereas MRI or CT only reveal the structure of the brain and obvious bleeding, the use of a Tracer allows a PET scan to identify areas of the brain that are utilizing compounds at a higher rate, which generally indicates a disease process.
Keep in mind that each of these brain imaging techniques looks for different evidence of injury, so it is incumbent on your medical provider to order the correct test based on your symptoms. The more specialized the test is, the more expensive it is as well.
Another tool practitioner who specialize in TBIs use are biomarkers. Biomarkers are measurable substances in the body, which indicate some sort of physiological response. For example, S100B, which is a protein abundantly found in the central nervous system (CNS), is released, or leaked by the cells of the CNS following TBI and can be actively measured through a blood sample. Other biomarkers include GFAP, which is also released by the CNS following trauma and is another indicator for TBI.
There are many other diagnostic tools available in treating TBI. Make sure to speak with your healthcare provider about these alternative techniques. Do not hesitate to contact a TBI lawyer at Nurenberg, Paris, Heller & McCarthy for information on how these techniques may or may not be helpful in pursuing an injury case. Call us today (216) 230 – 6384 or fill out a free initial consultation form today.
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