The Role Of The Psychiatrist In Treating Closed Head Injury

A victim of a traumatic brain injury or closed head injury often has a team of medical specialists to assist  in the recovery and rehabilitation.  Each member of the team has a different background, specialty, and purpose and it is the teamwork between them all that works best for the patient.

A psychiatrist is a physician (MD or DO) who is a specialist in treating mental illnesses, which could either be a result of genetic factors or an outcome of a trauma or accident. In the event of a closed head injury or a traumatic brain injury, the most inevitable outcome is impairment of the victim’s mental and cognitive faculties. The primary function of the psychiatrist is to diagnose and treat such impairments. The other specialty involved closely with the treatment of closed head injuries is the neurologist, who essentially handles the damages affecting physical abilities like seizures, etc. None of these physicians work independently. They work as a team.

There can be several sub categories of specialization amongst psychiatrists; some specialize in child psychology while others focuses on treating adult mental disorders. Some may even focus their practice on various types of addictions. As far as the psychiatrist treating a patient of traumatic brain injury is concerned, he relies on the test results provided by the neuro-psychologist, before he can give his recommendations for treatment.  His treatment may include medication in conjunction with counseling and therapy which play adjunctive roles. All these combined, help in the diagnosis, treatment and speedy recovery of the patient.

In the event of a lawsuit filed by the victim or his family a psychiatrist plays an even more important role. He usually provides the jury a detailed analysis of the closedhead injury and how it has affected the various critical faculties of his patient. He also narrates his own perspective of the expected outcome of the trauma and how it is likely to affect the patient for life. Such analyses are critical with regard to the final figure of claim settlement of a brain-injured patient.

Closed head injury and SPECT scan testing

A victim of a closed head injury or a traumatic brain injury is not only treated by a host of physicians belonging to various specialties, but the victim also has to undergo a series of tests to help with the diagnosis and treatment. One such compulsory testing is the SPECT scan test (Single Photon Emission Computed Tomography, a kind of nuclear imaging test displaying the pattern of blood flow to the various tissues and organs of the brain).

Depending on the severity of the consequences, such accident compensations can run into thousands.

Essentially, the SPECT scan test involves the deployment of two technologies – the computed tomography (CT) and the use of a radioactive material called the tracer. It is the tracer which helps the physician to track the blood flow to tissues and organs.

How is this test done? It starts with an injection of a chemical to the victim of a closed brain injury. This special chemical disperses gamma rays which the scanner can easily detect. In a way this test is not the same as a PET scan where the chemical is absorbed by the blood and the tissues. In the SPECT scan, the chemical remains in the blood stream helping to track the blood flow within the body. This type of scan is also less expensive and more easily available than even the high resolution PET scan.

A computer interprets the information gathered from the gamma arrays into the 2-dimensional images, which subsequently takes the form of 3-D images of the brain.

Considered to be more appropriate and sensitive than MRI or CT scans, the SPECT scan enables in the detection of speed of blood flow through arteries and veins within the injured brain. This type of scan is also frequently done for any evaluation study of medically uncontrolled seizures that demand surgical intervention. In such situations the SPECT scan provides the flexibility of scanning the brain in between (interictal) as well as during a seizure (ictal). This helps to identify the blood flow to areas of the brain from where the seizures begin.

All of us are aware of the seriousness of a closed brain injury. While the main focus is on the treatment of the condition, the one question that keep bothering us is what could be the short and long term implications when an individual has suffered a traumatic brain injury or TBI?

There is no definitive answer to this question. The reason for this is that it is difficult to assess the condition as well as predict its development and final outcome soon after the injury has happened. Closed brain injuries can be varied in type and severity and since the injuries sustained in the brain are usually complicated by nature, it may take months or even years to predict what is going to happen to the future of the patient concerned.

Any traumatic brain injury, irrespective of its severity, entails significant outflow of money, both in terms of diagnosis as well as treatment and rehabilitation of the patient. To add to this, chances are that the victim may not ever be able to pursue his professional life, remaining unemployable for the rest of his life. The most important point to note in such a situation is that the trauma could have been the result of someone’s negligence or carelessness, where the sufferer is a mere victim of circumstances.

To arrive at a pragmatic prognosis in the case of a closed brain injury, doctors study some important indicators which help them to come to a realistic conclusion. These include the duration and severity of the coma as well as the precise location and the dimension of the trauma sustained.

The duration during which a victim of a closed injury lies in a state of coma is a definite indicator of an expected post-trauma amnesia as well as the time he would require to recover. The first few hours after the accident are critical for the doctors, as this is the time when they assess the severity of the impact to the brain.

If the closed brain injury is mild in nature, then the victim can suffer temporary coma and amnesia for a few seconds stretching to a few minutes at the most.  Recovery in such cases usually stabilizes within a few days or weeks. On the other hand if the victim goes into a comatose state that lasts some weeks,  it is expected that the amnesia resulting from the trauma can also last several months with recovery stabilizing after months or even years.

To arrive at any conclusion regarding the long term implications of a traumatic brain injury, doctors depend on the location and dimension of the trauma site. Since there are specific areas of the brain that are responsible for the various cognitive and behavioral faculties, injury to such areas can be a reliable indicator of the kind and degree of impairment that the patient is likely to suffer.

In conclusion, it can be said that the recovery time from a traumatic brain injury is often directly linked to the severity of the trauma. The first step in the treatment of a TBI, immediately after the accident, is to reduce swelling, since this can reactivate the brain cells to resume functioning to some extent. The portions of the brain which have suffered permanent damage are to an extent helped by areas of the brain which have been left untouched by the trauma.

An important part of every patient’s traumatic brain injury recovery “team” is the Case Manager.   A case manager usually has a nursing background or is a counselor experienced with vocational rehabilitation programs.

A case manager is particularly helpful when the condition is a traumatic brain injury or a severe injury to the spinal cord. Here are some responsibilities of a case manager:

• Coordinating the overall treatment with multiple medical specialties including doctors and clinics.
• Locating the best doctors according to the victims’ specific needs.
• Scheduling doctors’ visits.
• Assistance with home renovation after the victim is released from the hospital, including building of ramps, procuring hospital beds, etc.
• Assisting the victim during recovery phase. Helping him to procure and use medical appliances like wheelchair, etc.
• Moderating discussions between the victim, his family and the health insurance company.
• Helping with all other services related to the victim’s post-hospitalization care, support, recovery and rehabilitation.

Under the Michigan No-Fault laws and the car insurance policy, a victim is entitled unlimited services from a case manager, except that the case management services that the victim is entitled to, must be relevant to his needs for recovery and rehabilitation.

It is common for the No-Fault insurance company to insist on a case manager of their choice. Since there are chances of conflict of interest, we recommend you to disregard this request. In fact, such case managers can jeopardize the chances of the victim getting complete medical treatment as well as other benefits.

For your information, the victim has every right to choose his own case manager instead of depending on the services of the case manager provided by the insurance company, to take care of his needs; like other medical benefits, the case manager can render services for as long as required.

Many times, the insurance companies  refuse to pay for these benefits. In case this happens to you, you have no other choice but to make a legal appeal so that the company pays for the services.  It is here that the Michigan car accident lawyers play a big role in getting your benefits paid.

Of all the accidents that cause traumatic brain injuries, those involving motorcycles are perhaps the most common.   The closed head injuries are usually serious, despite the biker wearing helmet and the rider has a higher risk of sustaining head injuries.   The worst part is that most of these injuries are caused by the negligence or callousness of some irresponsible person on the road.

While the surviving victim and his family get busy with the diagnosis and treatment of the condition, they usually forget to contact personal injury lawyers, who can provide the necessary help to the victim and his family to file claims for the damages, in case the accident has been caused due to another person’s negligence.

Any type of closed brain injury can cause irreparable damage to the life of the victim. Over and above the physical and emotional trauma which the victim suffers, the accident can impair him for life; break his family, marriage and relationships. It may cost him his job, leaving him unemployable for a considerable length of time.

The recovery of the victim of a traumatic motorcycle brain injury can take a long time. It involves huge expenses especially considering the long term care and medication costs involved for complete recovery.  The brain is not a simple organ and any damage sustained during a closed brain injury usually takes a long time to diagnose and treat.

Motorcycle accident victims can often obtain Michigan No-Fault Insurance Benefits to pay for medical expenses, lost wages, and other benefits for injuries suffered in the accident.  Many of these benefits are available for life.  In cases involving brain injuries, these benefits can pay for the necessary rehabilitation related to the recovery from the accident.

Today there are state-of-the-art treatment modules available which coach the surviving victim of a traumatic brain injury how to improve his social behavioral skills, including ways to interpret a seemingly complicated piece of communication. Several studies done on the subject report marked improvement in the social behavioral skills of victims of closed brain injury caused by motorcycle accidents.