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Brain Injury and Imaging Studies

All personal injury cases involve the element of damages or injuries to the plaintiff caused by the defendant. Injuries can range from a broken arm to severe and permanent brain damage. Brain injuries are particularly detrimental because they can have a wide array of physical and psychological effects.

Some of the effects of brain injuries include personality changes, mood changes, confusion, sensory deficits, balance issues, headaches, blurred vision, cognitive deficits, memory issues, difficulty concentrating, seizures, and depression. Brain injuries often require significant rehabilitation such as physical, speech, and occupational therapies. Even with therapy, these injuries often have a poor prognosis and are irreversible.

Brain injuries are diagnosed by radiologists through brain imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). CT scans are typically the first modality to evaluate a patient with suspected brain injury. CT scans are faster and less expensive to obtain compared with MRI. However, MRI’s are thought to be superior in terms of obtaining a more detailed image.

Brain imaging can show swelling, hemorrhaging, vascular malformations, blood clots, contusions, lesions, and white matter abnormalities. Cerebral white matter injuries occur when there is damage to the white matter in the brain, or fibrous tracts consisting of bundles of myelinated axons. This type of injury is often caused by oxygen deprivation at the tissue level (hypoxia).

Attorneys rely on brain imaging to prove that a plaintiff is suffering from a brain injury caused by the defendant’s negligence. However, proving that a brain injury exists can be challenging. Brain injuries are not always detectable immediately and are sometimes delayed in presentation. This is often the case when an infant suffers from hypoxic brain damage during the labor and delivery process. Sometimes the injury takes months to show up on brain imaging. Also, brain injuries are not always detectable on imaging—even though all the symptoms of brain injury may clearly exist. Innovative technology is aimed at solving this problem and is potentially able to detect brain injuries that are invisible and untraceable on CT or MRI scans.┬á

Diffusion tensor (DT) imaging is an MRI technique that makes it possible to image peripheral nerves in the body and neural tracts in the brain, including motor and sensory pathways. DT imaging measures the rate of water diffusion between cells to create a map of white matter tracts in the brain. The white matter is where microscopic neural tract losses and disconnections often exist.

DT imaging is a relatively new technology and is not available everywhere. Therefore, it’s subject to scrutiny in the setting of litigation. A plaintiff in New York is required to fulfill their burden of proof that testing procedures are reliable, and “generally accepted in the medical community”. As such, using DT imaging to prove brain injury in Court inevitably presents obstacles and is risky.

At a minimum, the fact that such technology exists is groundbreaking. Hopefully, this technology will help medical practitioners confirm and understand the extent of injuries previously undetectable and ultimately lead to tailored care and treatment for the patient.


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