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Temporary Brain Injuries Occur Even In Absence of Impact

10/04/12

Temporary Brain Injuries Occur Even In Absence of Impact

For decades, football coaches weren't removing football players from further play even after watching them suffer blows to the heads. Now that research studies are revealing players with concussions were and are still being sent back to play despite incurring head injuries, the U.S. Congress expressed fury and scheduled investigative hearings. While coaching staffs, the fans seated in stadiums, and millions of television viewers are finally demanding players suffering head blows be examined by physicians before sent back into the game, who, if anyone, is demanding that police officers more closely scrutinize accident victims before placing them under arrest for DUI charges?

While football team owners and coaches claim they "didn't know" so many players were experiencing head trauma during tough play, physicians and medical researchers have known for decades that motorists experience sudden movements causing them to suffer concussions even though their bodies didn't strike steering wheels, dashboards, airbags or other objects. The forces of acceleration or deceleration, even in the absence of impact with an object, can and do cause head injuries. Often referred to as "whiplash," these injuries don't just occur in high-speed wrecks, but also during typical "fender benders" occurring in rush hour traffic jams and crowded parking lots. The sudden forces caused by sharp braking or sudden swerving are by themselves capable of causing brain trauma - even when these swift defensive actions enabled drivers to avoid colliding into other vehicles or objects.

Experts now know concussions are vastly "under-diagnosed," due to a lack of public knowledge about head injuries and the absence of noticeable symptoms which could tip-off accident victims, witnesses and first responders to likely injuries. Alarmingly, 88% of all concussions are never diagnosed, according to a 2005 study reported in the Journal of Emergency Medicine. Concussions cause temporary "brain function dysfunctions, with symptoms commonly fading within the same week of occurrence. While the symptoms remain evident, at least some people are being wrongly arrested on drunk driving charges when their speech, dexterity and thought process has been temporarily hindered by undetected head trauma.

While the terms concussion, brain injury and head trauma are used interchangeably, head injury symptoms commonly occurring from minor accidents often arise not from harm to the brain itself, but due to the jarring of the vestibular system, the lower head area which comprises the region containing the inner ear that not only affects balance, but also the ability to focus both eyes while one's head is moving. Importantly, the smooth directional movement of the pupils within the eyes is also regulated by this brain-stem area. In DUI cases, police officers are trained to look for a jerkiness in the movement of pupils to form "reasonable suspicion" of drug or alcohol impairment, in order to proceed from an eye assessment referred to as Horizontal Gaze Nystagmus toward taking further measures leading to arrests. However, the pupils of persons who have not ingested alcohol or drugs but have suffered a concussion, demonstrate "Vestibular Nystagmus" with a slow migration of the eyes in the wrong direction, followed by a sudden jerking response. A police officer will almost certainly confuse this with similarities in eyeball patterns caused by ingestion of beer, liquor, prescription medication or illegal drugs. An inability to visually focus while one's head is in motion impedes a DUI suspect's ability to perform the standard law enforcement tests of walking a straight line during a heel to toe exercise, a leg raised while balancing on the other foot for 30 seconds and when taking coordination tests by placing the fleshy bottom of the fingertips onto the tip of the nose while keeping both eyes closed.

According to physicians who diagnose and treat patients with concussions, these are the most common signs and symptoms of head injury occurrence:

  • Vestibular Nystagmus and other unusual eye movements
  • Confusion
  • Dizziness
  • Blurred vision
  • Nausea or vomiting
  • Slurred speech
  • Fatigue
  • Reduced coordination
  • Inability to concentrate or to remain attentive
  • Impaired perception
  • Moodiness
  • Being glassy eyed
  • Walking problems, especially problems involving "station" and "gate," causing staggering or falling due to the decreased ability to alter the body's position. The "heel to toe" walking test administered by officers making DUI arrests is more likely to detect balance problems than the typical "Romberg" test by which physicians ask patients to demonstrate their balance while keeping the feet together while their eyes are closed and their arms are folded.

From training and experience, police officers become suspicious when motorists display quirky behaviors. Ironically, the very same "odd" behaviors law enforcement officers associate with DUI impairment comprise the set of symptoms physicians know to be caused by head trauma. Since only a minority of concussions result in unconsciousness or amnesia, there's no easy means of differentiating traits caused by head injuries from those arising due to alcohol or drug use. Further, anyone who had a prior concussion is more prone to re-experiencing this injury. With most people unaware of having suffered a concussion in the past, those experiencing reoccurrences don't know sudden vehicular movements leaving most other people unaffected will cause them to suffer from yet another concussion and to display traits which are identical to those exhibited by individuals who are drunk or high.

With symptoms typically disappearing within a week or two, or often within a few days, there's often no way for physicians to document the occurrence of a concussion. However, an accident re-constructionist can perform analysis to determine if acceleration, deceleration or other vehicular shifts and sways - even in the absence of a collision - could have been sufficiently stressful to induce a concussion. During trials, expert witnesses, including engineers and other professionals trained to assess vehicular accidents, are permitted to explain to jurors through their testimony, why assumptions made by police officers may be invalid. This "exculpatory" evidence, which casts doubt on the guilt of the defendant, can lead jurors to arrive at "Not Guilty" verdicts.

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