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Emergency Room Physicians Often Fail to Diagnose Brain Injuries

Despite the incredibly sophisticated medical tests and treatments available today, traumatic brain injury (TBI) victims can struggle to get an accurate diagnosis. This is especially true in emergency rooms. Hectic conditions and overworked doctors combine with the challenging nature of brain injuries to create an alarming number of missed TBI diagnoses.

This is troubling because the emergency room is usually the first stop for victims of head trauma, and brain injury victims who don’t receive an accurate diagnosis there may choose not to get follow-up medical treatment, even as they struggle with ongoing and debilitating brain injury symptoms.

In this article, we’ll explain why brain injuries often go undiagnosed and what you should do if you or someone you love has suffered head trauma and may be dealing with a brain injury.

Why Emergency Rooms Fail to Diagnose TBIs

TBI lawyerIn a 2016 study published in the Journal of Head Trauma Rehabilitation, researchers examined TBI-related emergency room records from 2009–2010 and concluded that 56% of patients who had a mild TBI (also known as a concussion) were not diagnosed during their emergency room visit.

The researchers gave several reasons for this problem. For one thing, standard clinical interviews and CT scans are common methods that ER doctors use to evaluate potential brain injury victims. Unfortunately, they simply aren’t accurate or sensitive enough to detect all types of TBIs.

In addition, some symptoms of traumatic brain injuries may not begin to show up until as much as a week after the victim’s initial trauma. Since emergency room doctors rarely follow up with patients after evaluation and testing, this can make it difficult or impossible for them to detect some of these delayed TBI symptoms.

All of this means that victims who have suffered serious head trauma and believe they may have a brain injury shouldn’t take a lack of diagnosis from the ER as the final word on their health.

Symptoms of a Traumatic Brain Injury

If you believe you or a loved one has a brain injury, you should seek medical treatment immediately — even if an emergency room doctor previously told you that you were fine. Brain injuries can affect victims for months or years after the initial head trauma, and many TBI victims find they have to undertake a long and frustrating journey just to receive a correct diagnosis so they can begin treatment.

The first step toward deciding whether you need to seek additional treatment is knowing what to look for. Some of the most common signs and symptoms of a traumatic brain injury, according to the Mayo Clinic, are outlined below.

Mild brain injuries (concussions):

Physical symptoms

  • Loss of consciousness for a few seconds to a few minutes
  • No loss of consciousness, but a state of being dazed, confused, or disoriented
  • Headache
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Difficulty sleeping
  • Sleeping more than usual
  • Dizziness or loss of balance

Sensory symptoms

  • Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth, or changes in the ability to smell
  • Sensitivity to light or sound

Cognitive or mental symptoms

  • Memory or concentration problems
  • Mood changes or mood swings
  • Feeling depressed or anxious

Moderate to severe brain injuries:

Physical symptoms

  • Loss of consciousness from several minutes to hours
  • Persistent headache or headache that worsens
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Dilation of one or both pupils
  • Clear fluids draining from the nose or ears
  • Inability to awaken from sleep
  • Weakness or numbness in fingers and toes
  • Loss of coordination

Cognitive or mental symptoms

  • Profound confusion
  • Agitation, combativeness, or other unusual behavior
  • Slurred speech
  • Coma and other disorders of consciousness

While anyone can suffer a traumatic brain injury, some groups are more at risk. In particular, very young children (0-4), young adults (15-24), and older people (75 or older) have the highest risk of suffering a TBI. In addition, men are more likely to sustain TBIs than women, and someone who has had a previous TBI or concussion is more likely to sustain another brain injury in the future.

How Can I Get an Accurate Diagnosis for a Brain Injury?

Even very competent doctors can fail to diagnose a brain injury, especially in a hectic environment like the emergency room. Part of the reason for this is that each brain injury is unique. While some TBIs show up readily on CT and MRI scans, other victims may find that these scans come back normal, even as they continue to suffer serious and debilitating symptoms from a devastating brain injury.

Fortunately, the field of brain injury diagnosis and treatment continues to advance every day. More advanced neuroimaging, innovative tests that involve analyzing the victim’s saliva, and more sophisticated neuropsychological assessments all offer hope to victims who are struggling to receive an accurate diagnosis for a suspected brain injury. However, most of these tests are not yet standard, and they may not be readily available to most patients.

If you believe you’ve suffered a brain injury because of someone else’s negligent behavior, but you’re still searching for a diagnosis, speaking with an experienced brain injury lawyer may help. While an attorney can’t diagnose your brain injury themselves, they should be familiar with the signs and symptoms. They may also be able to refer you to specialist doctors who can provide cutting-edge tests and assessments that aren’t available to most patients.

Perry Charnoff: Brain Injury Attorneys for Victims in Virginia, Maryland, and Washington D.C.

Even if an emergency room doctor or other physician told you that you were fine after suffering head trauma due to someone else’s negligence, you should seek additional medical advice and treatment if you’re suffering from brain injury symptoms. Perry Charnoff may be able to help connect you with the resources you need.

If you believe you’ve suffered a brain injury because of negligent behavior, please give us a call at (703) 291-6650 to schedule a free initial consultation and speak with an experienced TBI lawyer at no cost to you. You can also fill out our convenient online contact form and we’ll follow up to get in touch with you. We handle catastrophic injury cases on a contingent-fee basis, which means that you won’t pay attorney’s fees unless we achieve a financial recovery in your case.


Diseases and conditions: Traumatic brain injury. (n.d.). Mayo Clinic. Retrieved from

Korley, F.K., Kelen, G.D., Jones, C.M., & Diaz-Arrastia, R. (2016, December). Emergency department evaluation of traumatic brain injury in the United States. Journal of Head Trauma Rehabilitation, 31(6) pp. 379-387.

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.