John Maher:  Hi, I’m John Maher. Today, I’m speaking with Russell Guest and Richard Allen of Guest and Brady, a personal injury law firm in Greenville, South Carolina. Today, we’re going to be talking about common brain trauma in personal injury accidents. Russell and Richard, welcome.

Russell Guest:  Good afternoon, John. This is Russell here.

Richard Allen:  Hey, John, how are you doing?

John:  Great.

Richard:  This is Richard.

The Frequency of Brain Trauma in Accidents 

John:  How often do you, as personal injury attorneys, working with car, motorcycle, tractor trailer, and other accidents come across traumatic brain injuries?

Russell:  John, trauma to the brain can happen in just so many different types of scenarios in that they have to do with severity of the injury to the brain. They can be mild, but they occur frequently in accidents simply because when we are moving in one direction or we’re sitting still, and then some force causes us to immediately move to a different direction than we’re headed or where we were, these physics can often times cause an injury to our brain simply because it is getting hit from one side to the other, the brain is, or we might be slamming our head up against some hard object.

These can easily cause injury to the brain, which is not always easy to recognize immediately. They can manifest themselves later and they can be difficult to diagnose. It can be mild in the sense that it might just be [infrequent] headaches that someone’s experiencing. Or, [it can be a situation] where the [headaches] become increasingly more difficult to deal with where [they] are debilitating. Or, [the injury can me more severe] where there is an intrusion into the brain.

We’ve dealt with each of the levels of these types of injuries, and they happen very frequently. A simple rear‑end motor vehicle accident at a stop light where someone comes up from behind and runs into the back of someone can easily cause a traumatic brain injury, [as can] slipping on water on a floor where a store or an individual is negligent in putting water out and failing to warn the individual that there’s water [or some other substance] on the floor.

They fall, and they slam their head to the ground. This can certainly cause an injury to the brain. There are so many different common scenarios that people find themselves in that can cause these injuries, that causes us to have to deal with them frequently.

Common Types of Serious Brain Trauma

John:  What would you say are some of the most common serious brain injuries your clients are dealing with or even some less common ones?

Richard:  John, I guess the common traumatic brain injuries would be concussion, chronic headaches, migraine headaches, and some can be quite debilitating. Also some less common — we have a client now who suffered a traumatic CSF leak‑type injury. This client was involved in a T‑bone accident where his car was knocked on its side. He [was] initially treated by a family physician, and it took some time for him to ultimately understand his diagnosis.

I think, with this particular injury, as well as some of the more common injuries such as concussion or chronic headaches, it’s important to make sure that you’re getting in front of and seeing the right specialist or the right doctor, and that’s something that we could certainly help with. [You need to be] seeing a specialist that has the skill set to properly diagnose and treat these type injuries because often times, they’re very difficult to diagnose.

They manifest at a later date, but that does not mean that they are not related to a car accident, a tractor‑trailer accident, a motorcycle accident, or a slip and fall injury. That’s just another point I’d like to offer.

Less Common Types of Serious Brain Trauma

John:  What’s one of the less common type of injuries that you’ve seen?

Richard:  As discussed, this traumatic CSF leak, which stands for cerebrospinal fluid. We all have this lining around our brain in this protective fluid, and this client actually suffered a minor puncture in this lining, and the fluid actually was draining through his nose. He had blood shot eyes, severe headaches. While he ultimately resolved, these were very serious symptoms that were just impacting his life on a day to day basis [and] impacting his ability to work.

Ultimately, he was able to find the right specialist that was able to definitely diagnose him and treat him.

Can Brain Trauma Be Prevented?

John:  Are there ways that someone can prevent traumatic brain injuries from occurring in an accident?

Russell:  John, the ways to prevent these are ones that we are aware of as individuals through educational programs and through different mediums, or even instructions from our parents. My daddy used to say, “Son, always drive defensively.” That just seems like it’s a common sort of phrase that we need to be out there on the roadways aware of people that are surrounding us whenever we’re driving, and just drive in a defensive way so that we never get into that accident.

Also, wearing the seat belt. I know that sometimes people are so confident that not wearing a seat belt is even safer, but the statistics are just proving that assumption wrong [and] we need to wear our seat belt. I have been personally involved with these injury‑type cases for about 20 years now. I have seen many different types of cases and the seat belt is a great way to help prevent serious injury, not only physical injury to the body, but also to the head.

[There is] newer technology out there in terms of side air bags. If you can afford and purchase cars that have that type of technology in it, it is critical to have that technology to help you prevent from knocking your head up against solid objects that you might find to your left or to your right, depending upon wherever you’re sitting in the car, and that also prevent you from hitting the steering wheel with a front air bag or even the seat belt.

All of these things are helpful in preventing serious head injury whenever you’re involved in an accident. Child restraint systems are critical. We talk about these. They help [protect], not just [against] brain injury, but also in terms of physical injury.

We have a case right now, where there was an accident out on Interstate 85, a very busy traffic highway. It moves a lot of tractor‑trailers on it. One of our client’s vehicles became stalled, and it was a Honda Odyssey vehicle, which are wonderful cars.

They do have the newer technology on it, but this tractor‑trailer came barreling through on the highway and it was inattentive to the circumstances that were happening. He rammed into the side of this car at 70 miles an hour. There is no car that I know of that can sustain that kind of blow from a tractor‑trailer coming at 70 miles an hour.

As it passed through this car and sent it hurling down the roadway, there was a mother and a father in the front seat and there were two children, three and five years old, strapped in their child restraint chairs in the middle rows. Unfortunately, the mother and father both passed away from this accident. They were both killed, but their two children came away from this accident with no injuries whatsoever.

John:  Wow.

Russell: They had the three‑point restraints in them. Also, if you can imagine with a child seat, they have the cushions coming up on either side of their head. They were almost perfectly protected in a cocoon from this accident. It really saved their lives, and it saved them from any physical brain injury as well.

How Brain Injuries Complicate a Personal Injury Case

John:  That’s amazing. In a personal injury case where there’s a component of a traumatic brain injury, I would imagine that complicates things in that case. How can traumatic brain injuries complicate personal injury cases related to car accidents and other accidents?

Russell:   These types of injuries are often more difficult to diagnose. Clearly, we all know that there can be certain things that manifest themselves instantly and suddenly, [such as] the loss of consciousness [or the] inability to revive oneself. You can obviously go into a coma [or] in a vegetative state, and just never recover from that or have a long period of a coma or loss of consciousness.

Those are, clearly, ones that you can work with as far as understanding and proving that [the condition] is directly related to that accident. Those can be complicating, however, because we don’t know the future care required and we have to be able to work with experts from the field to understand that and be able to present that claim logically to an insurance company or to a jury, so that we get the proper recovery in terms of for future care that is required.

The more difficult types of head injury cases to show are those that are headaches, are chronic changes that happen to person’s mood or emotional stability. There is not really a diagnostic tool to say, “Yup, here it is. Here’s the change that happened in the brain and here’s where we know that this was caused by trauma.”

That is where it takes a combination of the specialists who have been working in the field, who understand the causes of certain types of injuries to the brain and how they might be caused by a trauma to use that combination to connect those [injuries] to the actual negligence of that third party, which is critical in these insurance claims and also claims we’re presenting to a jury.

We need to be able to start to understand those early on, getting the treatment to those as early as we can. If the symptoms by chance have magnified themselves later, then we still need to get in front of a specialist so that we can begin to work to connect those back to the actual accident date and to the accident event. They become more complicated and more difficult to connect sometimes, unlike a broken bone in their arm or the leg, something like that, something you know immediately happened at the time of the accident.

You definitely need to consult with an attorney because doctors necessarily are not interested in always connecting things back to the accident. They’re often times focused, appropriately so, on treating the symptoms and helping the individual to overcome that health issue that they’re experiencing. We, as attorneys, are helping ask the right questions to the doctors or to the medical professionals to get the experts there, to appropriately connect those injuries and symptoms back to the actual injury.

John:  All right, Russell Guest and Richard Allen, thanks very much for speaking with me today.

Russell:  Thank you, John.

Richard:  Thanks, John.

John: For more information about Guest and Brady, visit their website at or call 800‑903‑8101 or 864‑233‑7200.