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Most people, if asked what sort of incident would give rise to brain damage, would probably have a vision of something drastic, acutely traumatic, violent and obvious. The popular perception is of serious car smashes, high-speed motorcycle crashes, or ‘public’ disasters. But it is wrong to assume that brain injury can only arise in cases involving violent impact or dramatic events.

Mild traumatic brain injury can arise from sometimes the most trivial of incidents- a simple bump on the head or an acute flexion injury of the neck (aka the much-maligned ‘whiplash’ injury). Every year, A&E staff and doctors fail to spot that a patient has actually sustained some degree of brain injury. A study in 2008 reviewed medical documents from accident and emergency department examinations and found that 56% of those actually suffering a mild traumatic brain injury had no mention of it (or anything like it) in their medical records. To put it another way, doctors failed to spot actual brain damage in well over half of the patients they examined.

Where there was a confirmed loss of consciousness, this made it much more likely that the doctor would consider possible brain damage and make a note accordingly. Where there was only information about a relatively trivial trauma, and particularly where the patient was showing some sign of confusion, but no other significant symptoms, there was a strong tendency to completely overlook possible traumatic brain injury.

As made clear elsewhere on this site, just because a head injury is mild it does not mean its consequences are trivial. Even mild traumatic brain injury can give rise to very subtle but persistent symptoms that may only surface much later and can easily be overlooked. The failure and confusion of doctors to consider that possibility does great harm to those patients who are wrongly given the ‘all clear’ but then go on to suffer symptoms which they may not even realise are linked to the original incident.

With all medical services in the NHS under enormous financial pressure, pointing out further failings is never going to make anyone popular- but the long-term cost of coping with a patient who suffers from unrecognised brain trauma is likely to far outweigh the cost of picking it up correctly in the first place, and being able to do something about it.

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Head injury negligence: A&E fail to diagnose brain damage in 56% of cases