When physicians refer to traumatic brain injury, or TBI, they mean a closed head brain injury from an impact to the head or "diffuse axonal shearing" from a rotational acceleration and deceleration, the rotational movement of the head and brain resulting in a sliding of brain layers. Cavitaton can also commonly result in traumatic brain injury, the formation of microscopic bubbles from the rapid movement of the brain, which then can burst, causing brain damage as the brain moves back into place.

For TBI lawyers all traumatic brain injury is serious, and this is certainly true for those who suffer traumatic brain injury. However, medical doctors commonly characterize TBI as mild, moderate and severe, not to diminish the seriousness of "mild" TBI but to have a diagnostic framework with commonly understood terms.

In order to appreciate the distinctions made by the medical profession, the definitions of the National Institute of Neurological Disorders and Stroke (NINDS) are instructive. According to NINDS: "A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking."

There are differing definitions of mild traumatic brain injuryas the medical profession characterizes it. For example, the Mild Traumatic Brain Injury Committee, Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitative Medicine, states: "A patient with mild traumatic brain injury is a person who has had a traumatically induced physiological disruption of brain function, as manifest by at least one of the following: (1) any period of loss of consciousness; (2) any loss of memory for events immediately before or after the accident; (3) focal neurological deficits that may or may not be transient, but where the severity the injury does not exceed the following: (a) post traumatic amnesia not greater than 24 hours; (b) after thirty minutes, an initial Glasgow Coma Scale of 13 to 15, or (c) loss of consciousness of approximately 30 minutes or less."

For the person who suffers TBI, and for the traumatic brain injury lawyers who represent them, it must be appreciated that "mild" TBI isn't "mild," but can be a life changing event resulting in both physical symptoms and personality changes. The physical symptoms commonly include nausea, headaches, dizziness, sleep disturbance, fatigue and blurred vision. Cognitive changes can include difficulties in memory and speech as well as with attention and concentration. Behavioral changes can range from irritability or disinhibition to the opposite, emotional lability. Those who suffer mild TBI will often seem "different" to family and friends, and his relationship with those close to him may also suffer.

From the TBI lawyer's perspective, as we see explain in the article "TBI Lawyers Identification Presentation of Damages in Traumatic Brain Injury Cases"the initial difficulty is in demonstrating the existence of the "mild" brain injury that his client has suffered, a proof problem which is complicated by the fact that most mild TB will not be diagnosed. Emergency room doctors may be so rushed that they won't make the diagnosis and general practitioners commonly lack the necessary training to recognize the symptoms.

The National Institute of Neurological Disorders and Stroke categorizes moderate and severe TBI as follows: "A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation."

Those who are categorized as suffering moderate and severe TBI may have sustained a hemorrhage or concussion and more enduring loss of consciousness. Those who sustain skull fractures are more likely to be diagnosed with moderate or severe TBI. Those who suffer coma would with certainty be categorized as having suffered severe traumatic brain injury, but coma isn't essential to the diagnosis of severe TBI.

Often CT, MRI scans and other diagnostic technology of the brain can be used to identifying brain swelling, edema, or contusion, substantiating more serious brain injury. Skull x-rays and EEG studies are also useful in making the diagnosis of moderate or severe TBI. In addition to the Glasgow Coma Scale referred to above, the Rancho Los Amigos Cognitive Scale is commonly used to evaluate function as well as the rehabilitation of the patient with traumatic brain injury.

Finally, neuropsychological evaluation can be highly useful in TBI diagnosis. It doesn't depend upon a standardized scale. Rather it recognizes the individuality of the particular patient, evaluating his physical, mental and personality changes from before the incident which resulted in his traumatic brain injury.

Both medical doctors and the traumatic brain injury lawyers have at hand all these tools available to them to recognize the qualities of the brain injury their clients and patients have suffered. It is in the application of these tools, recognizing that all TBI is serious, that the injured individual is best served.