An injury to the brain has both cognitive and physical components.
While some imaging techniques, such as a CT Scan or an MRI study, may be able to detect physical injury to the brain as a result of trauma, many of these techniques do not asses the functional aspects of brain injury or how the brain damage impacts day to day functioning. Specialized studies, such as neuropsychological evaluation, functional MRI studies and diffusion tensor MRI studies may detect brain injury and brain damage that cannot be visualized through techniques that merely look at the brain’s structure.
Neuropsychology and Neuropsychological Testing
The field of neuropsychology concerns itself with the study and evaluation of the functional aspects of the brain. It is concerned with the behavioral expression of brain dysfunction.
The neuropsychologist uses a battery of tests to determine the patient’s attention, concentration, memory, planning skills and organization difficulties, speech and language deficits, and executive functioning (multi-tasking). The battery of tests will assist in diagnosing the cognitive, behavioral and intellectual deficits following a traumatic brain injury. These tests are standardized and have been administered over years to thousands of individuals.
The results of the neuropsychological testing will be helpful in not only diagnosing the specific deficits and disabilities from which an individual suffers, but also will aid in the management of brain damage and the brain injury rehabilitation plan.
It is important to consult with a qualified neuropsychologist to determine what tests need to be administered. While there are hundreds of neuropsychological tests available, there is no one test capable of assessing all functions of the brain. The ability to identify specific areas of brain dysfunction varies greatly among the available tests. Some tests are more specific and sensitive than others in identifying the specific areas of the brain where brain damage was sustained.
Neuropsychological tests, to be meaningful, must be both sensitive and specific in pin pointing the brain based deficits. The test must also be reliable so that if the same test is given by different examiners at different times, the results will be consistent.
Brain Imaging Studies
There is an old adage in medicine that absence of proof is not proof of absence.
This saying is particularly applicable to traumatic brain injury which often cannot be detected by imaging technology such as a CT scan or an MRI study. The failure to detect brain damage using imaging technology does not mean that a traumatic brain injury did not occur, it only means that the technology is not sophisticated enough to detect the microscopic damage to nerve fibers or chemical changes to these nerve fibers that are the cause of the brain damage.
Magnetic resonance imaging (MRI)
An MRI is a high quality three dimensional image of the brain without the use of x rays or other forms of radiation. A patient usually lies in a hollow tube and is exposed to high powered magnetic fields. The atoms of the brain react to the magnetic charges and a computer creates a detailed image as a result.
While an MRI is a powerful tool used to detect structural changes to the brain, the magnets have not been powerful enough to detect very microscopic damage to brain fibers. Newer MRI technology has been developed, such as the Tesslor 3.0 MRI which is twice as powerful as traditional MRI”s and allows a more detailed study of the brain. Brain damage is still missed and still stronger MRI’s need to be developed to detect all damage to the brain.
Advances in brain imaging technology may assist in showing the brain damage
Positive Emission Tomography (PET SCANS)
PET measures the blood flow or energy consumption of the brain. Through this measurement physicians are able to determine what areas of the brain are working and those areas that are not. Radioactive isotopes are introduced into the blood stream and are transported to different areas of the brain. The individual is asked to perform different tasks and measurements are then taken in regard to how hard the brain is working. These measurements are converted by computers into three dimensional images of the brain and the various areas are colored to show the amount of energy used.
PET SCAN technology has proved to be a very effective tool in detecting traumatic brain injury.
Functional magnetic resonance imaging (fMRI)
This technology compares brain activity under resting and activated conditions. It uses the technology of a traditional MRI and detects the increases in blood oxygen levels when brain activity brings fresh blood to different areas of the brain. By creating a map of this activity, scientists are able to track brain activities in healthy and brain damaged individuals.
Contact us for more information about these important brain injury tests
Many of the imaging techniques now utilized to detect brain injury are relatively new to medical science and may not be readily accessible at all medical centers.
The members of the American Academy of Brain Injury Attorneys have worked with many imaging centers and university hospitals where qualified neuro-radiologists can perform these tests when indicated.
The Academy brain injury lawyers understand that a negative imaging study does not mean that you have not suffered a brain injury, and are prepared to vigorously prosecute your case even in the absence of this evidence of brain damage.
You can obtain further information and request legal assistance for your brain injury case by contacting our President, Michael V. Kaplen, Esq. toll free at 1-866 BRAIN LAW or by e mail: firstname.lastname@example.org