At a Glance: The Reality of Post-Crash Concussions
- Can a concussion be missed? Yes. Research indicates over 50% of TBIs are missed in emergency rooms because standard CT scans only detect major structural damage, not microscopic cellular injury.
- What are the primary symptoms? Symptoms fall into four categories: Physical (headaches/dizziness), Cognitive (memory/concentration), Sensory (vision/tinnitus), and Emotional (irritability/personality changes).
- What if my tests were normal? A “normal” CT or MRI does not rule out a brain injury. If symptoms like “word-finding” difficulty or a “short fuse” persist for weeks, you may be experiencing axonal shearing that requires a specialized neurocognitive evaluation.
If you walked away from a collision with a tractor-trailer and were told your CT scan was “normal,” but you still don’t feel like yourself, you aren’t alone. Medical literature shows that emergency room professionals miss traumatic brain injury (TBI) diagnoses more than half of the time.
At MartinWren, P.C., we understand that a “normal” scan does not mean a “normal” brain. Here is the technical reality of how mild Traumatic Brain Injuries (mTBI) occur and why they are so frequently missed.
For a legal consultation with a personal injury lawyer, call (434) 817-3100
Why did my CT scan come back normal?
An ER’s primary goal is to identify life-threatening emergencies, such as a stroke or a massive brain bleed. A CT scan or MRI is a structural tool; it looks for major physical damage.
However, a concussion often occurs at a cellular level. When the massive force of a fully loaded commercial truck hits a passenger vehicle, it causes the brain to move violently inside the skull. This leads to axonal shearing—where the brain’s communication wires (axons) are stretched or torn. This damage is microscopic; you cannot see it on a standard CT scan any more than you can see a software virus by looking at the outside of a computer.
The Geography of a Brain Injury
To understand your symptoms, you must understand the “domains” of the brain. Depending on which area sustained the most force, your symptoms will vary:
- Frontal Lobe (Executive Function): Damage here leads to a “short fuse,” impulsivity, and difficulty making decisions.
- Temporal Lobe (Memory & Language): This often manifests as “word-finding” difficulty or forgetting conversations that happened just minutes ago.
- Occipital Lobe (Vision): You may experience blurred vision, double vision, or an inability to focus on a computer screen.
- Cerebellum (Balance): This results in dizziness and coordination issues that don’t improve with rest.
Common “Invisible” Symptoms
Brain injuries are often called “invisible” because the survivor looks fine on the outside. We categorize the symptoms into four key areas:
| Category | Common Symptoms |
| Physical | Intractable headaches, fatigue that rest won’t fix, and sleep disturbances. |
| Sensory | Tinnitus (ringing in the ears), sensitivity to light, and loss of taste or smell. |
| Cognitive | Difficulty concentrating, “brain fog,” and memory gaps. |
| Emotional | Anxiety, depression, and personality changes (e.g., an extrovert becoming withdrawn). |
What is the “Miserable Minority”?
While many people recover from a concussion within a few months, there is a group known in medicine as the “Miserable Minority.” These are survivors whose symptoms persist for months or even years. Without a proper diagnosis from a brain injury specialist, these individuals often feel gaslit by insurance companies who claim their “normal” CT scan proves they aren’t injured.
A Note for Families: Because the brain is the organ that perceives reality, a person with a TBI may not realize they are acting differently. If a spouse or child notices a personality shift or a “short fuse,” it is critical to seek a neurocognitive evaluation, even if the ER released you with a clean bill of health.
Why does the Legal Strategy Matter?
Handling a truck crash case involving a brain injury requires more than just knowing the law—it requires a deep literacy in medical pathology. Our Charlottesville personal injury lawyer team works with experts to bridge the gap between “normal” imaging and the very real cellular damage our clients face.
If you or a loved one has experienced these symptoms following a commercial vehicle crash, contact Bob Byrne at MartinWren, P.C. Our Charlottesville Brain Injury Lawyers know the medicine, we know the law, and we can help you prove your proper diagnosis.
For a deeper dive into brain injury articles, please visit:
Diffuse Axonal Injury: The Invisible Brain Damage that Can Occur in a Truck Accident
Post Concussive Syndrome After a Car or Truck Crash
Pituitary Gland Damage After a Virginia Truck Crash, Car Accident or Fall
The Complete Guide to Traumatic Brain Injury Cases in Virginia
Call (434) 817-3100 or complete a Case Evaluation form