Attorney Ben Schwartz conducts an interview with Dr. Steven Grossinger. They discussed a car accident Ben was in and the effects of obtaining a concussion as an injury from the auto accident.
Hi, I’m Attorney Ben Schwartz,
Ben: Today I have a special guest, Steven Grossinger. Dr. Grossinger is a neurologist, he’s a physician and medical doctor and he sees a lot of my clients in auto accident and workers’ compensation cases. A lot of the clients in my law firm, other attorneys as well in Pennsylvania and New Jersey and throughout the state of Delaware.
I asked Dr. Grossinger to come on and do a video with us today because I want to talk about something that happened to me a number of years ago. You know the story Steve, essentially, I was in a car accident. I was on I-95 and another driver who was driving a pickup truck and going way too fast, way over the speed limit, crashed into the back of my car. I got my car under control, there were no major lasting injuries but one of the things that I found really strange was that after I got the car pulled over, I could not find my cell phone. The police officer handed me his cell phone so that I could call someone to let them know what happened and I just couldn’t remember phone numbers. The memory just wasn’t there. I want to ask you, what’s your take on that Steve?
Dr. Grossinger: When there’s been a situation where there can be a head injury or concussion, there can be problems that arise right at the time of impact. In your circumstance, you’re in a car, you’re by yourself, it can be difficult to know the nature of the trauma.
You were hit forcibly from behind, a big vehicle hit another vehicle, one that was traveling at a high speed, so there are forces involved. Sometimes one might hit their head on the steering wheel or the windshield and it’s pretty clear. In other situations, our head gets driven back into even a nicely padded headrest. Still, we have to recall that our brain is floating in cerebrospinal fluid. Basically, in a fluid within our skull. The skull is like a hard box, the brain is soft and it’s floating. When there’s a sudden change, either being hit at a great force or suddenly stopping, the brain may still be driven into the hard aspect of the skull.
When you mention that moment there which ended up being an evaluation of your ability to concentrate by the police officer handing you the phone and you’re trying, on the spot, to remember a number. It makes me also think of on an athletic field, a high school student, a football player has a concussive episode and there has been more attention given to the on-the-spot assessment.
The bottom line is if you’re not necessarily stressed, it might have been a circumstance where there wasn’t a police officer there and giving you a task that required you to have a concentration in memory. You might have carried on and gone about your regular routine and maybe not be clear whether there could have been a concussion.
The classic presentation of a concussion is when the head is struck whether being hit by something like a baseball bat or in trauma like a car accident where there’s a sudden change or whether it being hit abruptly or stopping abruptly. There may be loss of consciousness, someone passes out. If someone were in the car with you and they saw that you look like you were asleep for a period of time and then awoke, then it’s pretty clear that there’s a concussion.
There clearly is a grey zone where there is no direct head contact. There is no loss of consciousness, but there may be problems such as headache, dizzy feeling, being just a little foggy and out of sorts, having problems with memory and concentration, being dizzy, having a change in vision. There can be even just like an emotional change where your family members realize that your fuse is shorter; you are irritable.
These are things when there’s been a concussion. It means that trauma has affected the brain in such a way that it is not functioning properly. So, after you’ve had an accident and if you do develop headaches which are different than what you’ve had. You find that your ability to think clearly, you try to text your family members and realize that it, you know today we don’t remember phone numbers as we were forced to when we were younger, but still, there are various tasks that we need to do. Trying to compose an email or a text, you might find it’s hard to put the words together. Talking, it may be hard to find the words.
So, after a traumatic incident you want to be mindful, has there been a change? Have you developed a headache? Do you feel like you are off-balance? Is it hard to focus your vision? Do you feel like your sleep has been thrown out of whack? Often in a circumstance like this, there’s a pain in other parts of your body that can be somewhat of a distraction.
Of course, the neck is definitely vulnerable. Just the anatomy of having the weight of our head, about 3 pounds, on our neck and then with there being a sudden force, you can get the classic whiplash-type effect. But again, I bring up that you may be suffering from pain in your neck, your back, your arms or legs, on top of the head-related symptoms, headache, troubles concentration and memory.
So, if you find that you have had an accident and you have some of these problems, you do want to bring it to medical attention. I think after an accident, naturally, no one expects it to come. I think you want to hope to just get back to normal and get back to your job, get back home. If you are bruised or bleeding, it’s pretty clear that you want to head for medical attention. But you know, I think if you have a question of, do you lose track of time? I mean is it hard to remember where you’re coming from or where you were going? Does someone on the scene point out to you that things were happening that you don’t have a recollection for? Do you suddenly become aware and realize that there’s an ambulance there already so that time has transpired?
I had a patient recently who was working in a plant and was struck in the head and went to the emergency room soon after. He said he did not believe that he had a loss of consciousness. As it turned out, they had video of the incident and he was out cold for more than a minute. So, you don’t know what you don’t know and it’s better safe than sorry. In many situations, after this, you may be fine just letting some time go and a week or two symptoms may resolve.
But there are circumstances where there can be persistent issues. I mean in a situation of an accident that’s no fault of your own, as a medical provider we want to be sure that we’re covering all bases medically, not missing anything. We do want to document the extent of the injury. Is it necessary to do further testing when the head has been hit significantly in such an accident as we’ve discussed.
There is some potential for bleeding or bruising within that brain that may require testing at a hospital or emergency room, a CAT Scan or MRI to be certain that there’s not more involved than that there appears to be. It may be a circumstance where it seems safest the same day of the accident to go directly there. It’s not uncommon to wake up the next morning and realize you thought you’re okay, but you may have a bad headache or other aching.
I think when in doubt, it’s nest to at least get some kind of screening whether it be today Urgent Care, your primary care physician, emergency rooms. You don’t want to overlook it. I mean clearly if you’re not able to really function properly, you notice it’s hard to feel confident behind the wheel or doing the things we do every day like typing a text or writing an email, reading the newspaper, watching TV, they have trouble keeping track of things, does your spouse or family member say they told you something that you forget soon after.
So, there are various signs and I think just point to the necessity to just get some further assessment. When in doubt let your family doctor or maybe a family member, just say you realized you’re not quite yourself and maybe put the onus on a spouse or friend to be sure that you get the wheels turning to the proper assessment. There are some circumstances where one may look okay but really be out of sorts.
Ben: That’s excellent information, again I’m Ben Schwartz. This is Dr. Steven Grossinger and we’re signing off. If you have questions about concussion please get in contact with us, we’ll get you hooked up with Dr. Grossinger and get you all better. Thanks for watching.
Dr. Grossinger: Thank you.