The Basics of Neuroimaging for Brain Injury
Here’s my fourth TBI blog for TBI attorneys, with tips from three traumatic brain injury seminars I’ll be lecturing at this summer. It’s another blog on objective manifestation. According to Michigan’s auto accident threshold law, an impairment must be objectively manifested in order for a car accident victim to recover damages for pain and suffering. And in order for an impairment to be objectively manifested, there must be a medically identifiable injury or condition that has a physical basis.
Objective manifestation is not required in closed-head injury, and even though most MRIs and CT scans will be normal, there are a variety of new more sophisticated imaging tests that may document traumatic brain injury.
Consider going beyond the basic MRI (magnetic resonance imaging) and CT (computed tomography) scan: The MRI and CT of the brain only shows us the engine. But we want to see if the engine is working.
Keep in mind that many health insurance plans do not want to pay for more advanced diagnostic tests — not because they’re not useful, and not because they’re not valid and reliable. Insurance companies usually balk because more advanced diagnostic tests are not meant to diagnose, but rather to confirm a diagnosis. After all, why would your doctor order a test that’s meant to support a diagnosis she has already found?
Yet objective diagnostic testing can have profound implications in making your client’s brain injury “real” for a jury. Here are some tests to discuss and explore with your doctors and TBI attorney.
* Diagnostic imaging that examines connectivity and diffusivity
* PET – Positron emission tomography
* SPECT – Single photon emission computed tomography
* SWI – Susceptibility-weighted imaging
* DTI – Diffusion tensor imaging, fractional anisotropy
* Quantitative MRI Analysis
* fMRIs – Functional magnetic resonance imaging
— Steve Gursten is a member of the American Association for Justice Traumatic Brian Injury Group and lectures on TBI throughout the country. He was recently invited to become the first Michigan traumatic brain injury lawyer to serve on the legal committee for the Sarah Jane Brain Project, a foundation that aims to create a model system for all children suffering from pediatric acquired brain injuries. In 2008, Steve received a trial verdict of $5.65 million for a TBI victim; the largest reported auto negligence verdict in Michigan for the year according to Michigan Lawyers Weekly.
— Photo courtesy of Creative Commons, by digital cat
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