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Do you have to lose consciousness in an accident to sustain a serious brain injury?

It is often suggested by insurance companies that no loss of consciousness following an accident means no possibility of a brain injury. Quite simply, this is a self serving conclusion which is contradicted by current medical science and is not true.

Both the Center of Disease Control and the American Congress of Rehabilitation have published guidelines for diagnosing brain damage that indicate a person does not need to lose consciousness. For a physician diagnosing a potential brain injury, the length of the amnesic episode surrounding the accident is more important than the duration of a loss of consciousness.

“Amnesic episode” means the amount of time that the injured person lost around the time of the accident. We often have clients who describe not remembering the ambulance ride to the hospital or any of their E.R. visit despite the fact that they were conscious and answering questions. These memory holes are considered amnesic episodes.

The medical community is nearly unanimous in its conclusion that one does not necessarily need to lose consciousness to sustain a serious brain injury. In fact, brain damage can occur even without physical head trauma.

An extreme example of this is Phineas Gage. Mr. Gage was a railway worker who was injured in a blasting accident. The blasting mishap occurred as they were trying to clear a path for rails through a ledge of solid rock. As a result of the blast, a 3 foot metal rod was shot through his head. The rod came to rest sticking out of the top of his skull.

Phineas Gage Phineas-Gage-1  Atterbury, Kammer & Haag, S.C

Amazingly, it is reported that Mr. Gage never lost consciousness and was even able to walk and talk within a few minutes of the horrific event. Clearly, he had a serious and permanent brain injury as was demonstrated with the radical personality changes that he later experienced. However, Mr. Gage never lost consciousness.

A more modern example is Troy Aikman, the former Dallas Cowboys quarterback. Mr. Aikman eventually retired from football because of a concussion syndrome. Mr. Aikman reports that he now has no recollection of the 2nd half of a Superbowl that he played in. Despite this obvious brain injury, he was able to guide his team to a win.

In conclusion, one does not need to lose consciousness in an accident to have suffered a serious brain injury.

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