Dementia After Traumatic Brain Injury?

Video Transcript:

Claude Wyle:

We have to prove it. That's our job, and now we have tools to be able to do our job more completely and to the betterment of our clients’ lives. 

Rob Rosenthal:

Could brain injuries increase your risk of dementia? Well, that's what we hope to find out right now, because that's what we're going to ask the lawyer on today's episode.

Hi again, everybody, I'm Rob Rosenthal with askthelawyers.com, and my guest is San Francisco attorney Claude Wyle who recently authored an article about this very subject.

I want to remind you that if you'd like to ask questions about your specific situation, head over to askthelawyers.com, go to the top of the page where you can click the button that says “Ask a Lawyer” and it will walk you right through the process right there.

Claude, good to see you. Thank you so much for making some time to help us out.

Claude Wyle:

Great to see you too, Rob. Thanks for having me. 

Rob Rosenthal:

So you wrote this article about TBIs and dementia, and before we get into that too much, you point out in the article that people think of TBIs and they think of athletes or something like that, but you say there are everyday people that can get TBIs. Tell me a little bit more about that.

Claude Wyle:

The traumatic brain injuries happen in many, many ways. Obviously, our exposure as personal injury lawyers is usually through motorcycle accidents, bicycle accidents, falls where somebody hits their head, or even car accidents where somebody's brain has been jostled around. Brain injuries happen way too often, and they happen even if you're wearing a helmet a lot of the time—although helmets really do help prevent a lot of brain injury. 

They're rampant. They're everywhere, and they're insidious because most of the time the medical providers at an emergency room are not really equipped to evaluate a loss of brain function. They're looking for a frank bleed, like, “Do I have to save this person's life? Is their brain bleeding so badly that we're going to have to go in and relieve the pressure?” They're not really looking yet whether or not this person who has suffered a concussion, which is a traumatic brain injury, whether they're going to have any long-term effects. So that's part of our job as attorneys who represent brain-injured people, and we've been doing this since I can remember. I've been a lawyer for about two-thirds of my life now, so ever since the first day we were working with brain-injured people and trying to help them.

Rob Rosenthal:

You mentioned concussions, and I know from previous discussions with you, you don't personally like it or believe it when people say, “Oh, that's a mild traumatic brain injury.” To me, it just doesn't make sense how something could be mild and traumatic. Explain that a little bit, about how you think there's no such thing as a mild TBI.

Claude Wyle:

Well, that's one of the things we say around here all the time. Sometimes people say, “Oh, that's just a concussion.” Well, a concussion is a mild traumatic brain injury by technical definition, but here at Choulos, Choulos & Wyle, we don't think there is any such thing as a mild brain injury, that's kind of an oxymoron to us. If somebody's brain is injured to the point where it shows up and they have symptoms, that produces a real danger that they're going to have long-term or even lifelong symptoms and it's something that needs to be teased out. 

My next article that's coming out on brain injury actually discusses some new research that's been done, and that has demonstrated that certain biomarkers in the blood taken right away after a head injury can demonstrate whether a person actually has a brain injury. One of the hardest parts of our job is trying to prove brain injury. Our client tells us, “Look, I've lost horsepower. I've lost the ability to think. I can't do math anymore. I can't calculate a tip at a restaurant. I get dizzy when I go up in the elevator.” But there's no big bleed on any test, so we're always looking for ways to prove what's going on with our client. So the “mild” traumatic brain injury is actually the most troublesome for us, because if somebody's in a coma for a long time and they wake up and they can't talk, it's pretty obvious. We represent people from mild traumatic brain injury—and I don't like that phrase—all the way through to a vegetative state.

So the vegetative state people, it's very easy to prove. The hard ones to prove are when somebody just can't think straight; they can't do their job anymore; they get fired from their job and they've had that job for 10 years and they've always done great, but now they just can't do it and they start getting bad review after bad review after bad review. But you look at them, you talk to them, and they seem kind of normal in normal conversation. You have to test far more deeply to really uncover the truth about brain injury.

Rob Rosnthal:

So this article that you wrote specifically about a connection between a concussion or what some call a mild TBI and degenerative disease like dementia. Tell me a little bit more about that connection.

Claude Wyle:

We work with a lot of doctors who represent survivors of brain injury. About five or six years ago, a neuropsychologist sent me an article saying that she and the researchers thought there was some connection between dementia down the road, or early onset of dementia, and brain injury when you're younger. Now studies have just come up and they demonstrate that it's not just from boxers who are punch drunk; we've all seen horrible stories about boxers who suffer so many hits to the head, little micro-traumas, but it's not just professional football players who have CTE that's only demonstrable on examination of their brain after they're passed away. It's demonstrable now. 

In a study of 15,000 people who suffered mild traumatic brain injury when they were younger, it shows that 25% of them who suffered the lesser forms of the traumatic brain injury—25% of them are more likely to have dementia at an early age when they get older. Now, if they suffer more than one traumatic brain injury—even a mild one—that jumps up to 50% more likely to suffer from dementia; and dementia is a loss of memory or cognitive ability. It's real. It's the ability to think. 

So one minor brain injury—and I don't like saying minor, I have to keep correcting myself—but what technically qualifies as minor can produce 25% greater chances of losing memory and thinking ability. Two even minor traumatic brain injuries ratchet up to 50% more likely to suffer from dementia at an earlier age. Then more studies have been studying the soldiers who come back, our veterans, and that shows more like a 50% chance of suffering from a concussion and then having dementia later. So it's being developed further. 

I'm so happy that the studies are being done. I'm not happy that people are suffering from earlier dementia, but what I am happy about is that we will be able to prove it, and this gives our clients who are suffering tremendous credibility now, where they felt very alone and oftentimes my partner and I were the only people really supporting them and believing in them and believing that this was real, and not just that they had too much stress or problems in their life or something that came from somewhere else, like just getting old. Now we have a connection.

Rob Rosenthal:

So, Claude, explain to me then why this information is important, say, to somebody in their 20s who has had a motorcycle accident and may have suffered a brain injury. Why is it important that you know—if you represent them—or that they know that this may happen years down the road? How does it affect them?

Claude Wyle:

Well, we have to prove the full nature and extent of our client's injuries, and we cannot speculate about what might happen in the future. It has to be more probable than not that they will suffer from whatever we're saying they're going to suffer in the future. So in order to prove that it's more probable than not has been very difficult so far, because trying to prove that they're going suffer from dementia somewhere way down the road, the case is going to be already done with trial; it’s going to be settled. How do you get your client compensated for something that's a maybe? So the more evidence we have—the more medical evidence we have—the more likely we will be able to actually get our clients compensated for something that we believe is going to happen to them in the future, and it's tremendously important because in California, you can't just recover for something that may happen, something you're scared about, it has to really be a likelihood. Now the medical evidence is taking us to a place where it is provable that it is a likelihood. This is going to mean more accurate, better, more complete compensation, and just as important, more accountability for the people who harm people by hurting their brains.

Rob Rosenthal:

Fascinating information. I love it every time we talk, Claude. Thank you so much for making some time to answer questions.

Claude Wyle:

Rob, it's great to talk to you and I look forward to talking to you again in the near future. Please keep an eye out for our next article because the biomarker stuff is also really exciting in terms of proving brain injury, and as I said, as lawyers we believe our clients, and we don't think there's anything as a minor brain injury, but we have to prove it. That's our job, and now we have tools to be able to do our job more completely and to the betterment of our clients’ lives.

Rob Rosenthal:

Well let's talk again when that article comes out about that.

Claude Wyle:

That sounds great. Good to see you. 

Rob Rosenthal:

That's going to do it for this episode of Ask the Lawyer. My guest has been San Francisco attorney Claude Wyle. I want to remind you, if you'd like to ask questions about your specific situation, head over to askthelawyers.com, click the “Ask a Lawyer” button at the top of the page, and we'll walk you right through the easy process. Thanks for watching. I'm Rob Rosenthal with AskTheLawyers™.

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