The document outlines the management of mild traumatic brain injury (TBI) cases, including how to identify symptoms and necessary evaluations. It highlights the importance of understanding TBI's extensive impact on a person's life and the need for proper medical guidance. Additionally, it emphasizes the importance of neuropsychological testing for accurate diagnosis and encourages legal advocates to become well-informed about TBI resources.

1. COMMON ISSUES IN HANDLING
A MILD TRAUMATIC BRAIN INJURY CASE
Edward K. Le
Edward K. Le, PLLC
135 Park Ave N.
Renton, Wa 98056
425 336 2255
www.edwardkle.com
edward@edwardkle.com

2. HOW TO DETERMINE IF YOU HAVE A CLIENT
WITH A POTENTIAL TRAUMATIC BRAIN INJURY

3. LOOK AT PARAMEDIC NOTES

4. CONDUCT AN INVENTORY OF YOUR CLIENT’S SYMPTOMS

5. HAVE CLIENT FILL OUT A CHECKLIST
• HEADACHE
• DIZZINESS
• MEMORY IMPAIRMENT
• IMPAIRMENT OF ATTENTION
• SLOWLED MENTAL
PROCESSING
• MENTAL AND PHYSICAL
FATIGUABILITY
• LOWERED FRUSTRATION
TOLERANCE
• APATHY/POOR MOTIVATION
• DEPRESSION
• PROBLEMS IN ABSTRACT
REASONING
• IMPAIRED LEARNING
PROCESS
• CONFUSION OF MENTAL
STATE
• DISTURBANCE IN SLEEP
• NAUSEA
• DECREASED TOLERANCE FOR
STRESS

6. FIND OUT
WHETHER THERE
WAS AN IMPACT TO
THE HEAD
Note: Note: Lack of
Direct Head Impact
Does Not Rule Out
TBI

7. DETERMINE WHETHER THERE IS
LOSS OF CONSCIOUSNESS
Note: Negative LOC Does Not Rule Out TBI

8. FIND OUT FROM FAMILY AND FRIENDS
IF THEY NOTICED SYMPTOMS FROM CLIENT

9. HOW TO ASSIST YOUR CLIENT

10. EDUCATE CLIENTS ABOUT T.B.I TO HELP THEM
UNDERSTAND THEIR CONDITION BETTER

11. GUIDE THEM TO PROPER PHYSICIAN
AND MEDICAL TREATMENT FACILITY

12. HAVE CLIENT USE JOURNALS TO ACCURATELY REPORT
SYMPTOM DEVELOPMENTS TO DOCTORS

13. ARRANGE FOR A NEUROPSYCHOLOGICAL EVALUATION

15. ENLIST THE HELP OF FRIENDS AND FAMILY
TO DOCUMENT THE INJURY AND COGNITIVE DEFICITS

16. PSYCHOTHERAPY
PHYSICAL THERAPYSPEECH PATHOLOGY
REHABILITATION COUNSELING MEDICAL MONITORING
GUIDE CLIENTS TO THE APPROPRIATE REHABILIATATION

17. ANTICIPATE AND ADDRESS THE
COMMON DEFENSES

18. A Mild Traumatic
Brain Injury Causes
Little Impact on Life

19. IN A REPORT FROM THE CENTER
FOR DISEASE CONTROL TO THE
U.S. CONGRESS, MILD
TRAUMATIC BRAIN INJURY CAN
HAVE PROFOUND IMPACT AND
CAUSE LIFELONG DISABILITY

21. SPINE INJURY AND CHRONIC PAIN
DEPRESSION AND STRESS DISORDER
COGNITIVE DISORDER FROM BRAIN INJURY
BALANCE/EQULIBRIUM DISORDER
CLIENTS WITH POLYTRAUMA ARE MOST LIKELY TO
EXPERIENCE PROLONGED INJURIES

22. MILD TRAUMATIC BRAIN INJURY AFFECTS
EVERY FACET OF PERSON’S LIFE
Functionality
Ongoing Medical
Care Needs
Quality of Life
Earlier Nursing
Home Enrollment
Activities of
Dailiy Living
FACT

23. There Must Be
Impact to Head to
Cause Brain Injury

24. RAPID MOVEMENT OR ACCELERATION/
DECELERATION CAN DAMAGE BRAIN TISSUEFACT

25. RAPID ACCELERATION/ DECELERATION CAN CAUSE
BRAIN TISSUE TO DAMAGE THROUGH IMPACT
WITH HARD BONY INNER RIDGES OF SKULL
FACT
THIS IS KNOWN AS A COUP-CONTRECOUP INJURY

26. There Must Be “Loss of
Consciousness” to
Sustain A Traumatic
Brain Injury

27. Profound Brain Damage Can Occur Without Loss
of ConscioussnessFACT
Case of Phineas Gage [Standard Case Study in Medical School]: Struck By Long Metal
Rod into Brain During Explosion. He Never Lost Consciousness & Was Awake and Alert
When He Reached a Doctor Hours later

28. Center for Disease Control, World Health Organization,
and American Congress of Rehabilitation Medicine All
Define Brain Injury As “Any Alteration in Consciousness”
FACT

30. A Negative Brain
MRI or CT Scan
Rules Out a
Traumatic Brain
Injury

31. In Mild TBI, Most Damage to Brain is Microscopic
& Rarely Shows Up on MRI or CT ScanFACT
Normal Axons
Are Less Than 5
Microns – Less
Than Size
Threshold for
Detection by
MRI or CT

32. Diffuse Shearing of Billions of Axon Occurs
in Traumatic Brain InjuryFACT

33. Billions of Axons Can Be Damaged Without
Detection By MRI or CT Through ShearingFACT

34. CHILDREN WITH
BRAIN INJURY
RECOVER
BETTER THAN
ADULTS

35. According to Center for Disease Control , Children
May Require Longer Recovery Time After a TBIFACT

36. A Younger Brain Is More Vulnerable to Damage Because As
Undeveloped Portions Mature From Previously Damaged
Areas, Normal Development Is Hard to Predict.
FACT

37. Mild Traumatic
Brain Injury Victims
Recover Quickly

38. MILD BRAIN INJURY CAN HAVE PROFOUND
IMPACT OVER A LIFETIMEFACT
ACCORDING TO CENTER FOR DISEASE CONTROL, PEOPLE WITH MILD BRAIN INJURY
MAY EXPERIENCE ACCELERRATED COGNITIVE AND FUNCTIONAL DECLINE WITH AGE

39. BRAIN INJURY CAUSES PEOPLE TO DEVELOP
DEGENERATIVE NEUROLOGICAL DEFICTS AS THEY
AGE OVER TIME
FACT

40. Symptoms of
Traumatic Brain
Injury Will Be
Immediately
Evident

41. MOST PATIENTS ARE NOT SELF-AWARE OF
COGNITIVE DEFICTS UNTIL OTHERS TELL THEM
FACT

42. MOST PATIENTS ARE NOT SELF-AWARE UNTIL
ENOUGH TIME PASSES TO WHERE THEY
RECOGNIZE A PART OF THEM IS “MISSING”
FACT

43. PATIENTS WITH BRAIN INJURY USUALLY SUFFER
OTHER PHYSICAL AND BODILY PAIN THAT DIVERT
THEIR AWARENESS OF COGNITIVE PROBLEMS
FACT

44. YOU CAN
RECOGNIZE A
PERSON WITH A
TRAUMATIC
BRAIN INJURY

45. BRAIN DAMAGE IS INTERNAL AND SYMPTOMS
ARE NOT OBVIOUS TO ORDINARY PERSONS.FACT

46. MOST TRAUMATIC BRAIN INJURY VICTIMS
DISGUISE THEIR INJURY TO OTHERS FOR FEAR OF
BEING INTERPRETED “INADEQUATE” OR “CRAZY”
FACT

47. TRAUMATIC BRAIN INJURY IS KNOWN AS AN
INVISIBLE INJURY AND A SILENT EPIDEMICFACT

48. Any Medical Doctor
Can Detect a TBI.
Since the ER or Family
Doctor Did Not, There
Is No Brain Injury

49. ACCORDING TO THE A.M.A AND NUMEROUS
PUBLISHED RESEARCH, MOST DOCTORS ARE NOT
PROPERLY TRAIN TO DIAGNOSE A BRAIN INJURY
FACT

50. BEST PRACTICE FOR MOST PHYSICIANS IS TO
REFER PATIENT FOR NEUROPSYCHOLOGICAL
TESTING WHICH IS MORE EXTENSIVE
FACT

51. NEUROPSYCHOLOGICAL EXAMINATION IS MORE
DETAILED THAN A MEDICAL VISIT AND PROVIDES
OBJECTIVE EVIDENCE OF SPECIFIC COGNITIVE DEFICITS
FACT

52. NECESSARY STEPS TO BE A
BETTER ADVOCATE
FOR YOUR CLIENT

53. STUDY AND UNDERSTAND THE SCIENCE BY READING
THE RELEVANT LITERATURE REGARDING TBI

54. RESEARCH THE RELEVANT GOVERNMENT
AND SCIENTIFIC SITES

55. National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/tbi/tbi.htm
National Rehabilitation Information Center
http://www.naric.com/
National Institute of Health
https://vsearch.nlm.nih.gov
Center for Disease Control
http://www.cdc.gov/traumaticbraininjury/

56. Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/traumatic-
brain-injury/
National Institute of Child Health and Human Development
https://www.nichd.nih.gov/health/topics/tbi/conditioninfo/
Pages/default.aspx
Brain Injury Resource Center
http://www.headinjury.com/
American Academy of Neurology
https://www.aan.com/Search/?q=traumatic+brain+injury

57. SPEND THE TIME TO MEET WITH
THEIR DOCTORS AND MEDICAL PROVIDERS

58. DEVELOP THE CASE EARLY
BEFORE YOU FILE THE LAWSUIT

59. Email: Edward@edwardkle.com
https://www.linkedin.com/in/edwardkle
https://plus.google.com/+EdwardKLePLLCRenton
https://www.facebook.com/EdwardKLePLLC
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