Traumatic Brain Injuries Routinely Overlooked in Emergency Rooms

The U.S. Centers for Disease Control and Prevention (CDC) estimates at least 1.7 million people suffer brain injuries each year. A vast number of traumatic brain injuries go undiagnosed and untreated, particularly in hospital emergency rooms.  

According to a University of Washington study, 56 percent of mild traumatic brain injuries went undiagnosed in emergency room visits. The study found that as many as 80 percent of all adults with a traumatic brain injury are discharged the same day without being admitted to the hospital. The study also reasoned that emergency rooms often focus on ruling out severe brain injuries through imaging, and do not thoroughly screen for brain injuries with negative imaging results and injuries with no reported loss of consciousness. These facts do not rule out a brain injury.

According to the CDC, negative imaging results in CT scans and MRIs also do not rule out brain injuries. In addition, per the University of Washington study, brain injury victims often deny simple questions regarding loss of consciousness but then confirm brain injury symptoms by recapping events that note memory gaps or periods of confusion.

In our law practice, many of our clients with severe orthopedic injuries also suffer from overlooked brain injuries. Despite the lack of initial diagnoses, many suffer from long-term, life-altering impairments. It is vital to monitor brain injury symptoms.

The key root word in “traumatic brain injury” is “trauma.” Brain injury specialists explain that brain injury victims have actual physical damage to the brain.  Brain injuries have a litany of symptoms, which include headaches, fatigue, depression, anxiety, irritability, ringing in the ears, sensitivity to light, mood swings, changes in vision, slow or foggy thinking, and cognitive impairment. These symptoms present in a variety of combinations.

Without an initial traumatic brain injury diagnosis, victims are not appropriately monitored and treated. The University of Washington study notes that undiagnosed brain injuries have clinical consequences. It is important for patients to be aware of brain injury symptoms; to continue to monitor the presence of symptoms even if a brain injury is not initially diagnosed; and immediately seek medical help if brain injury symptoms present.

Sources

Powell, Janet M., PhD, OT, Ferraro, Joseph V., MD, Dikmen, Sureyya S., PhD, Temkin, Nancy R., PhD, Bell, Kathleen R., MD. Accuracy of Mild Traumatic Brain Injury Diagnosis. Arch Phys Med Rehabil Vol 89, August 2008.

McInnes, K, Friesen CL, MacKenzie, DE, Westwood, DA, Boe SG (2017) Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment. A scoping review. PLoS ONE 12(4): 30174847. https://doi.org/10.137/journal.pone.0174847

Facts about Concussion and Brain Injury. Center of Disease Control, U.S. Department of Health and Human Services. www.cdc.gov/TraumaticBrainInjury.

Gaw, Christopher E. and Zonfrillo, Mark R. Emergency department visits for head trauma in the United States. BMC Emergency Medicine (2016) 16:5 DOI 10.1186/a12873-016-0071-8.

Trifan, Gabriela, Gattu, Ramtilak, Haacke, Ewart Mark, Kou, Zhifeng, Benson, Randall R. MR imaging findings in mild traumatic brain injury with persistent neurological impairment. Magnetic Resonance Imaging 37 (2017) 243-251, http://dx.doi.org/10.1016/j.mri.2016.009.