austinbar.org FEBRUARY 2025 | VOLUME 34, NUMBER 1
Harnessing Advanced Medical Insights to Strengthen Traumatic Brain Injury Cases Arielle Allen, LOAR PLLC
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raumatic brain injuries (TBIs) are among the most complex and impactful injuries encountered in injury cases. These injuries often lack visible symptoms, yet profoundly affect a person’s quality of life. Incorporating advanced medical insights from biomechanics, vestibular science, neurovisual medicine, and subconcussive injury research into legal strategies can provide attorneys with compelling evidence to prove causation, highlight injury severity, and secure appropriate compensation for their clients. The Science of Biomechanics: Linking Accidents to Brain Injuries Biomechanics provides critical insights into how physical forces from an accident lead to brain injuries. In TBI cases, understanding
these mechanisms is essential for connecting the injury to the event: Rotational Forces and Axonal Damage: Research shows that rotational accelerations—often more damaging than linear forces—are the primary cause of diffuse axonal injuries (DAIs). These injuries occur when nerve fibers stretch or tear due to the brain’s movement within the skull, a common scenario in motor vehicle accidents and falls. Subconcussive Impacts: Even impacts that do not cause fullblown TBIs can result in subtle but lasting brain injuries. Known as subconcussive events, these injuries often go unrecognized but contribute to cumulative neurological deficits over time.1 Quantifying Trauma: Using biomechanical principles such as Newton’s Second Law (Force = Mass × Acceleration) and delta velocity (ΔV), attorneys can demonstrate how the forces involved in an accident were sufficient to cause brain injury.2 By leveraging biomechanical evidence, attorneys can effectively address defense arguments that downplay the severity of the impact.
Vestibular Science: The Role of Balance and Dizziness Dizziness and balance issues are among the most common yet underdiagnosed consequences of TBIs. These symptoms, often rooted in vestibular dysfunction, significantly affect daily life and recovery. Peripheral Vestibular Disorders: Injuries to the inner ear structures, such as labyrinthine concussion or benign paroxysmal positional vertigo (BPPV), can cause persistent dizziness and imbalance. Central Vestibular Dysfunction: Damage to brainstem or cerebellar pathways due to diffuse axonal injury disrupts balance and coordination.3
Proving Impairment in Court: Objective tests like caloric testing, video head impulse testing (vHIT), and vestibular-evoked myogenic potentials (VEMPs) provide quantifiable evidence of vestibular damage. Therapeutic Interventions: Vestibular rehabilitation therapy has shown significant success in treating post-concussive dizziness, underscoring the need for ongoing care and justifying claims for long-term treatment costs.4 By presenting vestibular science Brain Injury on page 7.