Traumatic brain injury (TBI)

In plain English: a traumatic brain injury is damage to the brain caused by a blow, jolt or penetrating wound to the head. It ranges from a concussion to injuries that leave someone needing care for life.

How severity is graded

Doctors often use the Glasgow Coma Scale in the first hours. It scores eye opening, speech and movement from 3 to 15. Broadly, 13 to 15 is classed as mild, 9 to 12 as moderate and 8 or below as severe. They also look at how long you were unconscious and how long you had no continuous memory after the injury (post-traumatic amnesia).

"Mild" describes the first hours, not the long-term effect. Plenty of people with a mild TBI deal with lasting symptoms that affect work and relationships.

Changes that are easy to miss

Physical injuries tend to be recorded. Brain injury effects often aren't, because the injured person may not notice them. Families usually see them first:

• Short temper, impulsiveness or flat mood.
• Poor memory, planning and organisation.
• Exhaustion after mental effort.
• Losing track of conversations or repeating things.
• Changes in how they get on with a partner, children or colleagues.

Statements from family and friends about the before and after are often some of the most powerful evidence in a TBI claim.

What the claim needs to cover

Serious brain injury claims are among the most complex there are. Beyond pain and suffering, they may include lost earnings for life, care and case management, therapies, adapted housing, and the time family members spend caring. Experts often include a neurologist, neuropsychologist, psychiatrist, care expert and employment expert.

Capacity and deadlines

If the injured person can't manage the claim themselves, someone else acts for them. In England and Wales that's a litigation friend, and a large award may be managed by a deputy appointed by the Court of Protection. US states and Canadian provinces have their own guardian or representative processes. In the UK, the limitation period generally doesn't run while a person lacks capacity, and similar protections exist in many other places, but check the rules rather than rely on it.

Next: hiring an accident lawyer · rehabilitation · permanent impairment.

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