What Exactly is a Traumatic Brain Injury?

Traumatic Brain Injuries (TBI) can be caused by a wide range of incidents, such as; car accidents, falls, assaults, and being struck by an object to the skull. The brain is remarkably complex, and what could seem like a simple accident could have long-lasting effects. Generally, the brain can be damaged in one of two ways; by external injury, which would leave visible marks, or by internal injury, where the injury is not visible. External injury results when an object strikes the head or, in the alternative, the head strikes the object. Internal injury occurs when the brain moves violently within the skull cavity.

TBI ranges from mild to severe. Even though one common misconception is that a person needs to lose consciousness to sustain a TBI, this is not necessarily true. In cases of whiplash, the brain rapidly accelerates/decelerates within the skull cavity. This often results in impairment of the cerebral nerve cells and fibers.  Car accidents, roller coaster or amusement park rides, during sport activities, or by being punched or shaken are leading causes of whiplash. The damage sustained can be microscopic, leaving modern technology, such as CT scans or MRI scans, incapable of visualizing or diagnosing the injury.

Instead, trained physicians diagnose their patients using the modified Glasgow Coma Scale (GCS). The GCS is a neurological scale that objectively measures a person’s conscious state following a head injury. It specifically assesses a person’s eye, verbal and motor responses in order to determine the severity of head trauma.

Common symptoms of mild TBI may include: headaches, dizziness, loss of balance, nausea, mood changes, memory or concentration problems, sensitivity to light or sound, blurred vision, fatigue, difficulty sleeping or sleeping more than usual.

Currently, insurance companies rely on outdated “junk science” to defend against TBI claims. Instead of accepting the diagnosis provided by trained physicians that utilize the modified GCS neurological scale, they instead ask courts and juries to rely on common misconceptions that modern science has debunked, such as: the CT scan or MRI scan did not show visible damage therefore brain injury did not occur, a person must lose consciousness in order to sustain a brain injury, or insurance companies hire doctors that rely on limited facts and ignore an abundance of evidence, such as the circumstances of the head injury and the TBI symptoms affecting a person that manifests subsequent to the incident.

Fortunately, research continues that will lead to further awareness, diagnosis and treatment. The NFL and the Defense Department actively contribute to research efforts in mild traumatic brain injury. Additionally, the Obama Administration recently proposed $110 million in funding to further human brain research. Through these efforts, continued research, and the expertise of experienced brain injury attorneys, insurance companies will have a more difficult time hanging their hats on common misconceptions and antiquated science.

For more information on TBI’s and head trauma, call the the brain impairment attorneys of the Dolman Law Group for a free consultation and case evaluation.

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President Obama Promises $100 million to Brain Injury Research

In a promising sign for victims of traumatic brain injury, President Obama has announced a new brain mapping project that will fund research into the areas of Alzheimer’s, autism, stroke, and closed head injury. The project will allot $100 million dollars toward brain research and job creation. In support of this project, President Obama says, “As humans we can identify galaxies light-years away, we can study particles smaller than an atom, but we still haven’t unlocked the mystery of the three pounds of matter that sits between our ears.”

The BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies), will attempt to record the electrical activity of each individual cell of the brain and the neural circuits that connect those cells. The $100 million will go to several different federal and private research institutes to fund the development of new technologies that will help spur the brain mapping project, as well as studying the ethical and legal repercussions of the project. The research is expected to start on the brains of small animals like flies, worms and mice before moving on to the more complex human brain.

The BRAIN Initiative is receiving praise from many neuroscientists and researchers across the country. Scientific Director and CEO of the Max Planck Florida Institute for Neuroscience David Fitzpatrick, calls the project “spectacular.” According to him, “We need this fundamental understanding of neuronal circuits, their structures, their function and their development in order to make progress on these disorders.”

Not everyone is as enthusiastic about the BRAIN Initiative however. University of California-Berkeley fruit-fly expert Michael Eisen criticizes the project as being far too ambitions, claiming that such scientific innovations are not the result of “centralized bureaucratic projects, but rather from individual labs.”

Other critics of the project focus more on its economic impact; $100 million is a lot of money for a government currently in a national sequester, cutting $85 million in government spending. In response to these critics, President Obama focuses on the hundreds of jobs that will be created in the research and implementation of the BRAIN Initiative. President Obama also cites the former success of the Human Genome Project, stating “Every dollar we invested to map the human genome returned $140 to our economy  – every dollar.”

We have previously blogged about traumatic brain injuries and the difficulties involved in both the diagnosis and treatment of these injuries. While the causes of these injuries are generally understood, they can be extremely difficult to diagnose due to the wide range of symptoms the victim may suffer. Traumatic brain injury symptoms can range from obvious physical signs such as leaking spinal fluid from the nose or ears, to “hidden” symptoms like tearing of the brain tissue or blood vessels in the brain. Victims of traumatic brain injury may also suffer serious emotional impact as a result of the injury, such as severe depression, difficulty focusing or remembering, or a lack of impulse control. These emotional effects of traumatic brain injury have been cited as contributing factors in the recent suicides of former NFL player Junior Seau and country music start Mindy McCready.

Overall, it seems that President Obama’s BRAIN Initiative is a huge step in the right direction to understanding the causes and treatments of traumatic brain injuries and other previously misunderstood diseases of the brain. Hopefully this project will result in a deeper understanding of the “three pounds of matter that sits between our ears,” and benefit victims of all types of brain injuries and diseases.

For more information on traumatic brain injury, or if you or someone you know is currently suffering from a traumatic brain injury as the result of someone else’s negligence, contact the experienced brain injury law attorneys at Dolman Law Group for a free consultation and case evaluation. 727-451-6900.

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Higher Rates of Traumatic Brain Injury Among the Homeless Population

We have previously discussed the varying symptoms of traumatic brain injury- ranging from changes in the brain injury victim’s ability to understand and absorb new information or remember previously learned information, to less obvious emotional symptoms like mood swings and depression. Recently, the media has focused on the emotional impact of TBI in discussing the suicides of former NFL player Junior Seau and country music star Mindy McCready. It is thought that both suicides were the result of a severe depression caused by previous trauma to the brain. Recent research shows that suicide is not the only concern relating to the emotional effects of traumatic brain injury.

A new study suggests that homeless individuals have a higher occurrence of traumatic brain injury than the general population. The study reveals that up to 53 percent of the homeless population suffers from traumatic brain injury and, of those, most of the injuries occurred before they were homeless. Dr. Jane Topolovec-Vranic (who conducted the study), notes that low rates of employment are common among victims of TBI. The changes in abilities to focus on tasks, remember assignments, or concentrate for an extended period of time make it extremely difficult for victims of TBI to carry out ordinary work functions. Further, the ability to control impulses present in a normal brain may be substantially altered for the victim of a brain injury. Combined, these factors can contribute to an already high risk of depression, making it difficult for some TBI victims to hold a steady job following their injury. The study also suggests that the impairments to the brain following the injury “may increase the risk of remaining homeless.”

It is important to remember that it is not only the victims of the injury that suffer from its effects. The emotional impairments caused by the injury can have serious effects on the victim’s friends and family, who may not understand or be fully equipped to handle these changes. Additionally the ever-rising number of unemployed and homeless Americans places a burden on society as a whole, as well as on the National economy. It is for these reasons that the Brain Injury Association of America and other organizations like it, focus on researching both the causes and treatments for TBI, as well as raising awareness of its effects to the general public. The more we understand these types of injuries, the better equipped we will be as a society to deal with the personal, social, and economic results caused by traumatic brain injuries.

For more information on the emotional and fiscal damage caused by TBI, please contact the experienced traumatic brain injury attorneys at Dolman Law Group for a free case evaluation and consultation at 727-451-6900.

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Should Boxing be Banned in Light of Brain Injury Concerns?

Recently there has been a lot of focus in the media on dangers associated with playing professional sports- particularly regarding the risks and dangers of traumatic brain injury. There are risks associated with participating in high contact sports like football and hockey. Recently, developments in the area of TBI research have caused professional boxing to come under some scrutiny as well. The frequent blows to the head incurred by professional boxers can cause tearing to the blood cells in the brain which, in turn, damage the nerve cells surrounding the blood vessels. These injuries can cause “tangles” to the nerve cells in the brain that- new research suggests- can develop and spread resulting in severe and lasting brain damage including TBI and possibly Alzheimer’s disease.

In order to prevent boxers from sustaining serious and lasting brain injuries from their involvement in the sport, one leading neuroscientist suggests a simple solution: ban boxing. John Hardy, chair of Molecular Biology of neurological Disease at University College London’s Institute of Neurology, suggests allowing women’s boxing in the 2012 Olympics was “a terrible thing” because the sport of boxing rewards its fighters for inflicting the maximum amount of damage possible on their opponent’s brain.  Dr. Hardy is worried that boxing will now become a mainstream sport for women as well.

While it is no secret that being struck repeatedly in the head can lead to an injury to the brain- even over a short period of time- the idea of banning an entire sport from the Olympics or the professional sphere in general seems, frankly, ridiculous. Banning boxing because some professional boxers have sustained serious brain injuries is akin to banning cars because drivers can be seriously injured or killed in motor vehicle accidents. Instead, legislatures have taken more appropriate steps such as implementing several rules and guidelines in an attempt to limit the number of injured drivers as much as possible: wear a seatbelt, drive the speed limit, and obey traffic signals. Similarly, the recent media attention to the death of former professional football player Junior Seau has led the NFL to consider taking additional safety precautions to prevent TBI to its players.

It seems then that boxing could, and probably should, follow in the footsteps of the department of transportation and the National Football League. Implementing new safety regulations in professional boxing would allow for the enjoyment of the sport by participants and spectators alike, while reducing the risk of injury to the boxers themselves.

I would like to see a protocol implemented by the various sanctioning organizations that would require diagnostic testing on fighters at specific intervals.  Further, boxers should be forced to undergo clinical examination every year in order to be cleared to fight.

Of course the best way to prevent injuries to the brain is to avoid activities with high risks of injuries. But that is not to say that people do not have a right to participate in those activities should they choose to do so. The answer lies not in eliminating every possible cause of brain injury; such would be impossible. Instead, the focus should be on furthering the research and development of treating the injury.  Understanding this logic, the NFL recently teamed up with General Electric Co to bankroll a $60 million research project into the area of traumatic brain injuries. Perhaps on the issue of traumatic brain injury, the World Boxing Association should steal a page from the NFL’s playbook.

Matthew A. Dolman, Esq., is a Florida brain injury lawyer and routinely blogs about the subject of traumatic brain injury at www.tampabaybraininjuryblog.com.

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Mild TBI Can Result in Destruction of Soft Tissue

Mild Traumatic Brain Injuries affect your life in many ways, but TBI has also been linked to the death of brain tissue after the initial impact. Dr. Sergei Kirov is a neuroscientist at the Medical College of Georgia Regents University, and his latest work has related to researching the damage that a head injury can cause to the brain in the following hours after the initial impact.

After a TBI occurs, both swelling and reduced blood flow take place and connections between neurons begin to die. Smaller cells, also known as astrocytes have been known to swell significantly when an injury occurs. A neuron is typically surrounded by 25 astrocytes and when these small star shaped cells swell up they smother the neuron and connective branches they support. This causes a lot of danger to the brain because astrocytes are responsible for providing physical support, nutrition and biochemical support to the neurons as well as repair and scarring of the brain following an injury.

These neurons will only take so much before they run out of energy and stop functioning, even though it has been said that they will still survive for hours after this happens, possibly giving doctors enough time to help, unless depolarization takes place.

“Like the plus and minus ends of a battery, neurons must have a negative charge inside and a positive charge outside to fire,” Kirov said, and for the brain, firing is a way of communication.

If the injury is serious enough, spreading depolarization can occur and is known for killing brain cells and brain tissue. This occurs abundantly in individuals that suffer from a TBI and can be identified by swelling of neurons, distortion of dendritic spines, and silencing of brain activity. Depolarization can also occur without a brain injury; instead it is a healthy way of firing neurons. Researchers found that when depolarization occurred brain cells were completely recovered but were only partially recovered if injured.

Dr. Kirov is far from finished when it comes to studying the brain and head injuries. He stated that he plans on researching astrocytes and whether their swelling after an injury is a form of protection or a damaging reaction, as well as better ways to protect the brain from injuries.

Matthew A. Dolman, Esq., is a traumatic brain injury attorney.  He has built a reputation among his peers for successful outcomes obtained for victims of traumatic brain injury.  For more information or to schedule a free consultation and case evaluation, please call the injury law attorneys at the Dolman Law Group today at: (727) 451-6900.

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Winter Sports and Brain Injury

It is very common to hear about concussions when discussing football or a recent auto accident, but many forget that snowboarders and skiers are just as susceptible to head injuries. Concussions are the most common injury that snowboarders face when riding but for them, they would prefer a concussion over a broken bone. These young adults see head injuries as an easier recovery process compared to an ACL tear or a broken ankle, but what they often fail to comprehend is the long-term prognosis for victims of a closed head injury.

Kevin Pearce, winter X-Games snowboarder, suffered six concussions; the last one ended his career for good. Three weeks prior to his career ending accident, Pearce was practicing and took a hard hit to the head. Instead of taking the necessary time to heal and recover from this concussion, he decided that on December 31, 2009 he would give the half pipe another try.  Unfortunately his attempt was unsuccessful and once again he fell on his head, but this time he did not sustain a concussion. Rather, he suffered a traumatic brain injury that completely altered his life. Kevin Pearce was flown to the University of Utah Medical Center and was not released until January 26, 2010. He was then transferred out of critical care and moved to Craig Hospital in Denver, Colorado, a rehabilitation center specializing in traumatic brain injuries. It was not until June 2010 that Pearce could reunite with family and friends.  However, he will never again snowboard at the X-Games.

Traumatic brain injuries (TBI) can affect a person for the remainder of their life, and take years to possibly recover from. When suffering a TBI there are many long term symptoms that may manifest such as: changes in social behavior, constant headaches, numbness in the limbs, loss of coordination, confusion, restlessness, agitation, memory and vision loss, etc. Athletes whose hobbies are also their careers are much more likely to experience an injury such as a TBI.  At this time, most athletes fail to appreciate or acknowledge the long-term effects of concussions are something that concerns them. Hopefully after reading about other athletes such as Kevin Pearce and the effect it had on his career, it could change some perspectives.

Matthew A. Dolman, Esq., is a traumatic brain injury attorney.  He has built a reputation among his peers for successful outcomes obtained for victims of traumatic brain injury.  For more information or to schedule a free consultation and case evaluation, please call the injury law attorneys at the Dolman Law Group today at: (727) 451-6900.

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Identifying Common Cause of Traumatic Brain Injuries: Whiplash

There are several myths surrounding the ever-expanding field of Traumatic Brain Injuries (TBI). One of the most common myths associated with TBI is that they are only caused by a sudden or severe blow to the skull. We see this type of TBI all the time with professional sports athletes, especially in the NFL. Hollywood has also chosen to focus almost solely on this type of TBI as well (think “50 First Dates”, “While You Were Sleeping”, or pretty much any other romantic comedy in which someone suffers a head trauma and a resulting amnesia). This type of TBI is quickly recognized and diagnosed due to the obvious trauma to the victim’s head. However, this is not the only type of TBI.

Another type of TBI is often caused by an injury commonly associated with automobile accidents- whiplash. Whiplash refers to injuries to the cervical spine column due to a quick over-extension of the muscles in the neck and upper back. When whiplash occurs however, it is not just the neck that experiences that rapid back and forth “nodding” motion.

When whiplash occurs, the brain can experience what is called a “coup contrecoup” injury. This type of TBI is caused by a fast acceleration or deceleration of the head and brain and requires no direct external contact to the victim’s head. We all learned in grade school that Newton’s laws of motion require an object in motion to stay in motion until it is acted upon by an equal and opposite force. As we see all too often with rapid acceleration/deceleration injuries, the brain is not immune to this law. When a vehicle is forced to stop abruptly- as in a collision- the force of the wreck sends the head and neck forward and can even propel the victim’s brain into motion. When this occurs, the equal and opposite force that stops the forward momentum of the brain is the skull itself. This collision between the brain and the inside of the skull sends the brain jolting backwards until it hits another wall- the back of the skull. As you can see in the video below, a whiplash can easily result in severe trauma to both the front and back of the brain and can lead to severe injury to the victim.

So why do we only hear about brain injuries associated with some type of external trauma? Well, Traumatic Brain Injuries reveal themselves in many ways including both Primary and Secondary Damages. Primary damages are those that occur at the time of the injury. An injury that is the result of an external trauma- such as the victim’s head being slammed against a steering wheel or dash board- will likely present with obvious primary damage such as a skull fracture or a contusion at the site of the injury, making them very easy to identify. Meanwhile, victims of the less obvious internal injuries caused by an acceleration/deceleration trauma may experience more hidden symptoms, such as blood clots in the brain itself, tearing of brain tissue and/or blood vessels, or even damage to the nerve fibers in the brain.

Secondary injuries- those occurring after the time of the actual trauma- can be extremely dangerous to victims of acceleration/deceleration TBIs as they may go undetected by medical personnel until days or weeks after the accident occurred. These can include infection, brain swelling, oxygen deprivation, death of brain tissue, and internal bleeding within the skull.

According to the Brain Injury Association of America, automobile accidents account for over 17% of all reported traumatic brain injuries. If you’ve been in an accident and you’ve developed common TBI symptoms such as dizziness, irritability, headaches, changes in appetite, confusion, memory loss or physical impairment, it is extremely important, that you are evaluated by a physician with training in the diagnosis and treatment of coup contrecoup injuries.

If you are the victim of a traumatic brain injury, you will almost certainly need the assistance of an experienced personal injury attorney to assist you with recovering for the debilitating damage associated with TBI. Florida insurance companies aggressively defend their claims and may try to deny a claim or pay a minimum settlement amount on a “whiplash only” case, not realizing the very real possibility that the victim may be suffering from an undiagnosed traumatic brain injury caused by the collision. The experience brain injury lawyers at Dolman Law group will work just as aggressively for your interests. We actively litigate auto accident and motorcycle accident related cases in Pinellas County, Hillsborough County, Sarasota County, Manatee County and Pasco County. Located in central Pinellas County (Clearwater), Dolman Law Group is easily accessible to injury victims in St. Petersburg, Tampa, Palm Harbor, Dunedin, Safety Harbor, New Port Richey, Pinellas Park, Largo and Kenneth City. If you or someone you know is suffering from a traumatic brain injury, call our office today for a free consultation. 727-451-6900.

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Suicide Attributable to Brain Injury

In the United States, suicide is among the leading causes of death with around 40,000 deaths each year. Most people are likely to associate suicide with addictions or mental illness, but not many have considered the odds of a suicide resulting from a traumatic brain injury.

On February 17, 2013, Country singer Mindy McCready was found dead on her front porch after committing suicide, in the same spot her boyfriend killed himself just a few months prior. Unfortunately for the last 5 years of her life, McCready was not getting the spotlight she had grown accustomed to. Instead, headlines for McCready revolved around her battling the courts for custody of her children or criminal charges that she has incurred. But what many people are not aware of is Mindy McCready was in an abusive relationship and previously sustained a brain injury because of the abuse.

More than 90 percent of all injuries attributable to domestic violence occur to the head, neck or face, which makes victims of abuse susceptible to brain injury. The most common manner for victims of domestic violence to sustain said injuries include being hit with an object to the head, pushed against a wall, punched directly in the head or face, shaking of the body, being strangled, or being shot in the face or head.  Brain trauma often results in a loss of consciousness, memory or concentration problems, mood changes or mood swings, depression, and anxiety.  Most victims lack knowledge concerning injuries to the brain and attribute their issues to something else. Without knowing that the brain injury may be linked to domestic violence, doctors will not be able to refer them to the correct rehabilitation facility.

In a study conducted by Dr. Jonathan Silver and his colleagues, individuals with a history of traumatic brain injuries are far more likely to commit suicide or have serious psychiatric issues compared to those who have never had an injury to the brain. Mindy McCready was a victim of a brain injury and this may have played a role in her untimely death . Brain injuries are the number one leading cause of death and disability for young adults and without the proper information on how to prevent, identify, and treat this injury; the deaths will continue to be on the rise.

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Utilizing Diffusion Tensor Imaging to Illustrate Mild TBI

Mild traumatic brain injury (TBI) is a very common disorder and affects over one million Americans each year. A recent study has linked mild traumatic brain injury to abnormalities in the white matter of the brain, also known as “potholes”.

With over two million soldiers in the United States alone, an estimated 10% of these men and women have experienced TBI while being deployed overseas. Due to the fact that TBI is so difficult to diagnose or detect, there are likely to be thousands of soldiers who are not aware that they have sustained a TBI. The University of Iowa research team used a MRI based brain scanning technique called diffusion tensor imaging (DTI) to study the brains of ninety-three (93) veterans. Utilizing DTI, researchers found that soldiers returning home from Iraq and Afghanistan with mild TBI have more abnormalities in the white matter of their brains compared to those who have not experienced TBI.

Studies have demonstrated that the severity of the injury and increased severity of cognitive alterations, (which affects the ability to make a decision) are the only two criteria influencing the number of potholes; as opposed to age, duration since trauma, coexisting psychological problems, or post-traumatic stress disorder.
A “mild” traumatic brain injury may be nothing more than minor damage to the axonal fibers. However, this may result in long lasting very significant consequences. In fact, it is not uncommon for the symptoms to grow worse over time. As a personal injury attorney, I often utilize the services of Neurologists, Neuropsychologists, Vocational Rehabilitation specialists and other professionals to illustrate the long lasting consequences of a brain injury and to assist my TBI client on the road to recovery.

If you would like more information on claims involving an injury to the brain, call the injury law attorneys of the Dolman Law Group for a free consultation and case evaluation at:
(727) 451-6900.

-Matthew A. Dolman, Esq.

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Inspiration Found From Brain Injury Victim

This morning, during my foray through social media and the news, I came across a YouTube video entitled: “Re-learning My Broken Memories, Inspirational Monologue – by Sam Way.” As an attorney who represents brain injury victims and enjoys sharing inspiration, the headline interested me. I clicked the link.

The video opens to a young man, in his late teens, walking onto a stage through a door. He looks around, shaking, as if trying to see if all his limbs joined his journey through the portal. Finally, he notices a chair in the center of the stage and disjointedly walks to the chair.

As his tremors continue, the young man peers at the door, pondering its very existence. The tremors build to a climax as the first word, “YOU!” rockets out of his mouth with seemingly every ounce of the young man’s strength.

I found myself struck with an unnerving skepticism as to the veracity of the video. He displayed classic signs of a traumatic brain injury, but they were so prevalent that I thought, “this may be some sort of cruel and elaborate ruse.” I immediately paused the video and looked into its uploader’s profile.

That person was Sam Way, known as sammiemagoo2 via YouTube. Sam uploaded around 1575 videos at the time of this writing. The video showed the same young man that I viewed on stage struggling through a number of workouts and describing his life, including videos on learning to walk with a cane and swimming underwater.

I wanted to know more about who this person was and what he was about. The answer came from one of Sam’s videos where he and a member of his team read a local newspaper article.

Sam was found in October 2004, at 10 years of age, Sam was found wrapped in a sleeping bag, drugged, and possibly hit by a train. Authorities found Sam’s father nearby wrapped in blankets and he was eventually convicted of criminal negligence. Sam’s video has an inserted visual comment that states, they “still don’t know why [his father] did that.

At this point, I was convinced and sought to hear the rest of Sam’s message. Between long pauses, Sam gives some perspective on his life, stating that he “would never have seen this life coming when [he] was younger… would never accept someone who had a brain injury.” He admit that he “would have just made fun of them for their disability… they were too different.”

Sam admits to some of the issues that we’ve discussed on this blog too. He never thought that someone would help him out and stated, “I thought his life was over.” After a long and quieting pause, Sam rejoiced, “Look at me now! I can walk and talk and do so much more!”

Sam concludes with a final message to all “normal” people. “…STOP picking on other people because of their differences… they just may be helping YOU when YOU go through a life changing event, like a Traumatic Brain Injury.”

As a traumatic brain injury attorney, I’ve seen situations similar to Sam’s. Admittedly, they’re typically milder in severity. Yet, I was entranced by Sam’s willingness, determination and strength in sitting down in front of a camera to do something so challenging.

Check out more of Sam’s videos at his home page on YouTube: http://www.youtube.com/user/sammiemagoo2


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