TheAthletesLawyer

Lauren Holtzman of ABRAMS LANDAU, Ltd., investigating another triathlete's brain injury and head trauma case

Juries are skeptical. It is important to have objective evidence. In other words, juries may “filter out” subjective complaints UNLESS there are supporting documents, photos, x-rays or other OBJECTIVE evidence.

It is for this reason that Herndon brain injury attorney Holtzman requests x-ray, MRI and CT Scan reports and definitive diagnoses from potential clients, rather than treatment notes and subjective journal entries. If you have been in a bicycle crash, attacked by a dog, struck by a car, disabled due to a defective bike component, bitten by someone’s pet, injured while cycling, or the victim of someone else’s negligence or unlawful behavior, call us at once. Remember, the more evidence, information and documentation we can gather immediately after the crash or animal attack, the greater the chances of success later in Court.

Trial lawyer triathlete Landau will be a volunteer at the Reston Sprint Triathlon.

Volunteer Doug Landau giving Aquathlon Champion Beth Baker her registration packet

What has happened is that rotational and other movements of the brain during trauma has resulted in injury to numerous axons in both cerebrum and brain stem. Brain injury trial attorney Doug Landau explains that this can happen as the result of a sharp, fast back-and-forth movement of the skull, or a rapid twisting of the head from an impact, or a high-velocity combination of straight and curvilinear motions of the body above the neck. This type of injury has been seen at autopsy following many days after the traumatic injury. In other words, the movement of the head during an accident causes the string-like nerve cells (axons) to stretch, tear or rupture. These specialized cells may not be able to repair or regenerate themselves. There may be swelling, inflammation or disruption of the electrical impulses that make up our “wiring.”

The brain is the “command and control center” of our “wiring system” points out brain injury lawyer Doug Landau. And when the wires are severed or damaged, the signals do not work as intended, with short, and sometimes long term consequences. If you or someone you know has been suffered a brain injury or has symptoms of a head injury, it is critical that they get proper medical attention and seek experienced legal assistance. At ABRAMS LANDAU, Ltd., we help adults and children from around the world with brain injury and head trauma cases.

This important concept explains both short and long term neurologic deficits in patients whose trauma did not produce either contusions, hemorrhages or lacerations sufficient to account for the deficits. Frequently, the latter lesions are minimal but the deficit is severe. Sometimes, notes Herndon Reston brain injury lawyer Doug Landau, there is a minimal laceration (cut) or not cut at all, but the neurological damage is significant. This is often harder on the innocent crash victim because they have no “Red Badge of Courage” to display to friends, family or their physicians to buttress their claims of disability, deficit and suffering. This, in turn can cause anxiety, depression and fear, especially in cases in the long and trying litigation process adds Landau.

The American College of Physicians (”ACP”) recommends that you see a doctor IF:

1. Pain runs down the leg below the knee
2. The leg, foot, groin or rectal area feels numb
3. Fever, nausea or vomiting, stomachache, weakness, or sweating occurs
4. Bowel or bladder control is lost
5. Pain was caused by an injury
6 Pain is so bad you cannot move around
7. Pain does not seem to be getting better after 2-3 weeks.

The ACP and the American Pain Society published guidelines on the diagnosis and treatment of low back pain in December, 2007.  For a “Summary for Patients” of these guidelines, go to www.annals.org/cgi/reprint/147/7/

Many people have low back pain at some time in their lives. It can become chronic, meaning that it comes and goes over months to years.

In the “ANNALS OF INTERNAL MEDICINE” it is suggested that

IF YOU HAVE LOW BACK PAIN:
*Do not lift heavy things or do strenuous work
*Try to keep doing everyday activities an walking, even if it hurts
*Do not stay in bed longer than 1-2 days, because it can make your recovery slower

Dr. Allen Delaney of Commonwealth Orthopedics has treated many patients with traumatic and chronic back pain

TO HELP YOU FEEL BETTER, TRY SOME OF THESE THINGS AT HOME:
*Medicines from the drug store to reduce pain, (acetaminophen, ibruprofen - read the labels !)
*Heating Pads or hot showers
*Massage

See tomorrow’s post for suggestions from the ACP as to when you should see a doctor. For more information, in English and Spanish. try the American Academy of Family Physicians (http://familydoctor.org/online/famdoces/home/common/pain/treatment/117.html)

In the previous posting, brain injury lawyer Doug Landau listed Direct Effects of head trauma and brain injuries.  In addition to those sometimes permanently disabling effects of an impact or blow involving the skull and brain, the Herndon Reston trial attorney notes that there are “Secondary Effect” which can also be quite devastating to the innocent victim of a bike or car crash.  Listed below are Secondary Effects of brain injury and head trauma:

B. SECONDARY EFFECTS

1. Cerebral edema or swelling

2. Herniations of brain tissue

3. Infection

4. As a result of traumatic brain damage, there may be permanent localizing neurologic defects or post-traumatic epilepsy.

www.pathology.vcu.edu/WirSelfInst/trauma.html

Doug Landau gives swim star Beth Baker a noogie, which will not result in brain damage or a closed head injury

A. DIRECT EFFECTS

1. Skull fracture

2. Hemorrhages–epidural, subdural, subarachnoid or parenchymal

3. Lesions to brain–contusion, laceration [ the most minor “lesion” has no identifiable gross or microscopic counterpart in human material and is the concussion which produces unconsciousness].

4. Diffuse axonal injury [DAI]

When the head is struck, it often moves until it is abruptly brought to a stop against a solid object. At this moment, the brain continues moving for a brief instant until it hits the bony prominences inside the now stationary skull.  The skull does not give with this impact.   The brain does.  This is often accompanied by a stretch of the nerve endings.  Sometimes this “stretch” goes beyond the nerve’s limit, and microscopic nerve (axonal) tears occur.   These are not detected by regular x-rays.  Sometimes, the injury to the moving brain takes place at a site opposite the point at which the skull was initially struck. This type of injury is called “contra-coup,” as opposed to a “coup” injury occurring on the same side as the initial impact (coup = blow, French; contra-coup = opposite the blow).  Traumatic lesions, whether they are the product of closed or penetrating injuries, and whether they are coup or contra-coup, may be said to have direct effects, and secondary effects.  Direct Effects and Secondary Effects will be addressed in the next post.

http://www.pathology.vcu.edu/WirSelfInst/trauma.html