Concussion & Traumatic Brain Injury (TBI) from Car Accidents
Motor vehicle crashes cause approximately 190,000 traumatic brain injuries in the United States each year, making them the second leading cause of TBI after falls. You do not need to hit your head to sustain a concussion — the rapid back-and-forth motion of a collision can cause the brain to impact the inside of the skull. Any loss of consciousness, confusion, or persistent headache after a crash is a medical emergency.
First Responder Insight: A patient who is awake and talking after a crash can still have a life-threatening brain bleed. We use the Glasgow Coma Scale, but even a perfect score does not clear the brain. Any head involvement at an accident scene gets a CT at the hospital. Period.
Understanding TBI: Mild, Moderate, and Severe
| Severity | Loss of Consciousness | Post-Traumatic Amnesia | Glasgow Coma Scale |
|---|---|---|---|
| Mild (Concussion) | 0–30 minutes | Under 24 hours | 13–15 |
| Moderate | 30 min – 24 hours | 1–7 days | 9–12 |
| Severe | Over 24 hours | Over 7 days | 3–8 |
Concussion Symptoms After a Car Accident
Immediate Symptoms (At the Scene)
- Headache or pressure in the head
- Confusion, feeling "foggy" or dazed
- Brief loss of consciousness
- Nausea or vomiting
- Slurred speech
- Blurred or double vision
- Sensitivity to light or noise
Delayed Symptoms (Hours to Days Later)
- Worsening headaches
- Memory problems and difficulty concentrating
- Sleep disturbances (sleeping too much or too little)
- Irritability, anxiety, or depression
- Fatigue that does not resolve with rest
- Balance and coordination problems
Call 911 — These Are Emergencies
- One pupil significantly larger than the other
- Extreme drowsiness or inability to be awakened
- Repeated vomiting (3+ times)
- Seizures
- Worsening confusion or agitation
- Weakness or numbness in extremities
- Clear fluid from nose or ears (may be CSF — a skull fracture sign)
Post-Concussion Syndrome (PCS)
When concussion symptoms persist beyond 3 months, the condition is diagnosed as post-concussion syndrome. Approximately 20–30% of concussion patients develop PCS. It is not a sign of malingering — neuroimaging and neuropsychological testing can document objective deficits.
PCS symptoms include:
- Chronic daily headaches
- Cognitive impairment ("brain fog") affecting work performance
- Depression, anxiety, emotional lability
- Tinnitus (ringing in ears)
- Sensitivity to light and sound persisting for months
PCS significantly increases the value of a TBI claim — because it demonstrates ongoing, documented disability beyond the initial injury.
How TBI Is Diagnosed
- CT scan: Emergency imaging — rules out brain bleeds, skull fractures, and hematomas
- MRI: More sensitive than CT for diffuse axonal injury and white matter damage
- Neuropsychological testing: Objective cognitive evaluation — critical for documenting PCS in litigation
- IMPACT or computerized cognitive testing: Measures reaction time, memory, processing speed against baseline norms
- fMRI / PET scan: Advanced imaging used in severe cases and litigation to show metabolic brain changes
TBI Treatment
Mild TBI / Concussion
- Physical and cognitive rest — avoid screens, reading, strenuous activity in first 24–48 hours
- Gradual return-to-activity protocol — step-by-step reintroduction of physical and cognitive demands
- Sleep hygiene — consistent schedule; avoid sleep aids that mask symptoms
- No alcohol — significantly worsens recovery
- Follow-up with neurologist if symptoms persist beyond 2 weeks
Moderate to Severe TBI
- ICU management of intracranial pressure
- Surgical intervention (craniotomy) for hematomas or skull fractures
- Inpatient rehabilitation — physical, occupational, speech therapy
- Neuropsychiatric care for behavioral changes
- Long-term cognitive rehabilitation programs
TBI Settlement Values
| TBI Severity | Outcome | Typical Settlement Range |
|---|---|---|
| Mild (concussion, full recovery) | Complete resolution | $20,000 – $80,000 |
| Mild with PCS | Ongoing symptoms 3–12 months | $50,000 – $200,000 |
| Moderate TBI | Partial recovery, some deficits | $150,000 – $500,000 |
| Severe TBI | Permanent disability | $500,000 – $5,000,000+ |
Key Takeaway
A concussion after a car accident is a brain injury — not "just a bump on the head." Insurance companies frequently undervalue TBI claims, particularly mild ones, because the injury is invisible on standard imaging. Neuropsychological testing and a documented symptom history are essential to proving the full impact of your injury and securing fair compensation.