Hilda Sibrian - Houston's Injury Attorney

Traumatic Brain Injury (TBI)

Traumatic brain injuries, commonly referred to as TBIs, are among the most complex and life-altering injuries seen in personal injury cases across Houston and Harris County. Unlike fractures or soft-tissue injuries, a brain injury can permanently alter how a person thinks, feels, works, and interacts with others. Even so-called “mild” brain injuries can produce symptoms that linger for months or years, affecting employment, family relationships, and overall quality of life.

In a large metropolitan area like Houston, traumatic brain injuries arise in many contexts: high-speed vehicle collisions on I-45 or Loop 610, trucking crashes along I-10 and US-59, industrial and refinery incidents, construction site falls, and serious pedestrian impacts. Because symptoms may not be immediately obvious and diagnostic findings can evolve over time, TBIs are frequently misunderstood, underdiagnosed, and undervalued by insurance companies.

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A traumatic brain injury is defined as an injury that disrupts normal brain function due to an external force. This force may be caused by a blow, jolt, rapid acceleration-deceleration, or a penetrating object. Importantly, a person does not need to lose consciousness to sustain a traumatic brain injury. Many TBIs occur even when the individual remains awake and alert after the incident.

From a medical standpoint, TBIs are categorized based on mechanism of injury, severity, and anatomical damage. Brain injuries happen by:

  • Sudden acceleration or deceleration of the head, such as in a car or truck collision
  • Direct impact to the skull from a fall, strike, or falling object
  • Rotational forces that cause the brain to twist within the skull
  • Penetrating trauma that breaches the skull and brain tissue

When the brain moves violently inside the skull, it can collide with bony ridges of the cranial vault, stretch delicate nerve fibers, or rupture blood vessels. These processes may result in bruising of brain tissue, bleeding inside the skull, or microscopic damage that does not appear on initial imaging but still produces profound symptoms.

What are the Classifications of Traumatic Brain Injuries?

Clinicians generally classify traumatic brain injuries into three severity categories, though these labels can be misleading in legal and practical terms.

Mild traumatic brain injury

Often referred to as a concussion, mild traumatic brain injuries may involve brief confusion, dizziness, headache, or memory gaps surrounding the event. Despite the term “mild,” these injuries can produce persistent cognitive and neurological symptoms, especially if not properly treated or if compounded by additional head trauma.

Moderate traumatic brain injury

Moderate traumatic brain injuries typically involve longer periods of confusion or loss of consciousness, more pronounced cognitive impairment, and visible abnormalities on imaging studies such as CT or MRI scans.

Severe traumatic brain injury

Severe TBI is associated with extended loss of consciousness, significant structural damage to the brain, and a high risk of long-term disability or death. These injuries often require intensive care, neurosurgical intervention, and prolonged rehabilitation.

Unfortunately, many insurers try to minimize documented brain injuries by labeling it “mild,” even though the injured person continues to experience disabling symptoms long after the accident. Our job as attorneys is to fight this classification and represent your injury for what it is.

What are the Types of Traumatic Brain Injuries?

Traumatic brain injuries are not a single condition but a spectrum of injury types, each with distinct medical implications and prognoses. Understanding these categories is critical in evaluating the seriousness of a Houston brain injury case.

Intracranial Hemorrhages

Traumatic brain injuries can also involve bleeding within the skull, known as intracranial hemorrhage. The location and extent of bleeding determine both the medical urgency and long-term outcome.

  • Epidural hematoma involves bleeding between the skull and the dura mater and can be rapidly fatal if not treated promptly.
  • Subdural hematoma occurs beneath the dura and is common in high-impact crashes and falls. These may present acutely or develop slowly over time.
  • Subarachnoid hemorrhage involves bleeding into the space surrounding the brain and can cause severe headaches, neurological deficits, and long-term complications.
  • Intraparenchymal hemorrhage refers to bleeding directly within brain tissue and is often associated with significant neurological impairment.

Concussion

A concussion is the most common form of traumatic brain injury and occurs when mechanical forces disrupt normal brain function. At the cellular level, concussions involve metabolic changes, altered neurotransmitter activity, and temporary dysfunction of neural pathways.

Symptoms may include headaches, dizziness, nausea, difficulty concentrating, memory impairment, light sensitivity, sleep disturbances, and mood changes. Imaging studies such as CT scans are often normal, which leads insurers to incorrectly argue that no real injury occurred.

In reality, concussions can produce long-lasting effects, particularly when symptoms persist beyond the expected recovery window, a condition known as post-concussion syndrome.

Diffuse Axonal Injury

Diffuse axonal injury, often abbreviated as DAI, is one of the most severe and devastating forms of traumatic brain injury. It occurs when rapid acceleration and deceleration forces cause widespread shearing of axons, the long nerve fibers that allow brain cells to communicate.

DAI frequently occurs in high-speed motor vehicle collisions and trucking accidents, which are common on Houston highways. These injuries may not be visible on standard CT scans and often require advanced MRI techniques for detection. Patients with diffuse axonal injury may experience prolonged unconsciousness, significant cognitive deficits, or permanent disability.

Penetrating Traumatic Brain Injury

A penetrating traumatic brain injury occurs when an object breaches the skull and enters brain tissue. While less common in typical personal injury cases, penetrating injuries may arise from industrial accidents, construction incidents, or severe vehicle collisions involving debris.

These injuries carry a high risk of infection, seizures, and permanent neurological damage and almost always require surgical intervention.

Cerebral Contusion

A cerebral contusion is essentially a bruise of the brain tissue. These injuries commonly occur in the frontal and temporal lobes, areas responsible for judgment, impulse control, memory, and emotional regulation.

Contusions may worsen over time due to swelling or delayed bleeding, making follow-up imaging critical. Depending on severity, cerebral contusions can result in permanent cognitive or behavioral changes.

How Do I Know If I Have a Traumatic Brain Injury?

One of the most dangerous aspects of a traumatic brain injury is that symptoms are not always immediately obvious. Many Houston accident victims walk away from a crash or fall believing they are unharmed, only to develop serious neurological symptoms hours or days later. Because the brain controls cognition, emotion, movement, and sensory processing, symptoms can vary widely depending on the type and location of the injury.

Cognitive and Behavioral Symptoms

Cognitive impairment is one of the most common consequences of traumatic brain injury. These symptoms often interfere with work performance, decision-making, and daily functioning.

Common cognitive and behavioral symptoms include:

  • Difficulty concentrating or sustaining attention
  • Memory loss, especially surrounding the accident
  • Slowed information processing
  • Confusion or disorientation
  • Poor judgment and impaired executive function
  • Irritability, mood swings, anxiety, or depression
  • Personality changes that are noticeable to family members

In Houston personal injury cases, these changes are frequently reported by spouses, coworkers, or supervisors before the injured individual fully recognizes the extent of the problem.

Traumatic brain injuries also produce a wide range of physical and neurological symptoms, many of which worsen with activity or stress.

These may include:

  • Persistent or worsening headaches
  • Dizziness or vertigo
  • Nausea and vomiting
  • Sensitivity to light or sound
  • Balance and coordination problems
  • Slurred speech
  • Weakness or numbness in the limbs
  • Seizures

Certain symptoms, such as repeated vomiting, seizures, unequal pupils, or worsening confusion, are considered medical emergencies and require immediate evaluation.

Sleep disruption is common after a traumatic brain injury and may involve insomnia, excessive sleepiness, or irregular sleep-wake cycles. Sensory disturbances, including blurred vision, double vision, ringing in the ears, or altered taste and smell, may also occur.

These symptoms are frequently dismissed by insurance companies as unrelated or subjective, even though they are well-documented consequences of neurological trauma.

Persistent headaches are one of the most common long-term complaints after traumatic brain injury. These headaches may resemble migraines, tension-type headaches, or cervicogenic headaches and often require ongoing medical management.

Vestibular dysfunction, which affects balance and spatial orientation, can cause chronic dizziness, vertigo, and an increased risk of falls. These conditions are particularly disabling for individuals working in physically demanding or safety-sensitive occupations.

Treatment and Recovery After a Traumatic Brain Injury

Diagnosing a traumatic brain injury requires more than a single test. Physicians rely on a combination of clinical evaluation, imaging studies, and symptom progression to determine the nature and severity of the injury. In Houston, this process often begins in an emergency department and continues through specialty care.

Initial Neurological Evaluation

Emergency physicians perform a neurological examination to assess mental status, orientation, speech, motor strength, reflexes, and sensory function. One commonly used tool is the Glasgow Coma Scale, which evaluates eye response, verbal response, and motor response to help classify injury severity.

A normal Glasgow Coma Scale score does not rule out a traumatic brain injury, particularly in cases of concussion or diffuse axonal injury.

Imaging Studies

Imaging plays a critical role in identifying structural brain damage.

  • CT scans are typically the first imaging modality used in emergency settings. They are effective at detecting skull fractures, intracranial hemorrhages, and mass effect.
  • MRI scans are often ordered when symptoms persist or when CT findings do not explain neurological deficits. MRI is more sensitive for detecting diffuse axonal injury, small contusions, and microhemorrhages.

Many Houston hospitals within the Texas Medical Center routinely use advanced MRI techniques when standard imaging does not capture the full extent of injury.

Neuropsychological and Specialty Testing

When cognitive symptoms continue, physicians may refer patients for neuropsychological testing. These evaluations measure memory, attention, executive function, language, and processing speed. Results often provide objective evidence of impairment, which is particularly important in traumatic brain injury litigation.

Patients with dizziness or balance problems may also undergo vestibular and ocular motor evaluations to assess inner ear and visual system involvement.

Evidence and Documentation in Houston Traumatic Brain Injury Claims

Traumatic brain injury claims are evidence-intensive. Because TBIs often involve delayed symptoms, subtle neurological deficits, and imaging that may appear normal early on, thorough documentation is essential to establish both medical causation and the full scope of damages. In personal injury cases, the strength of a brain injury claim often turns on the quality, consistency, and continuity of the medical and factual record.

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Our legal team operates on a contingency fee basis, meaning: you don’t pay us to start your case and if we don’t win, you don’t pay any legal fees. Our fee would be a percentage of the compensation obtained for you and your family in the settlement. So you don’t have to pay us out of your pocket, and there are no upfront payments, either!

Common Sources of Liability in Houston Traumatic Brain Injury Cases

Common Sources of Liability

Motor vehicle collisions remain the leading cause of traumatic brain injuries in Houston. Liability may rest with negligent drivers, commercial vehicle operators, or corporate employers under vicarious liability principles.

Truck accidents often involve additional layers of responsibility, including trucking companies, contractors, and maintenance providers. High-speed impacts and vehicle mass differences make brain injuries particularly common in these cases.

Premises liability incidents, such as slip and falls or falling-object injuries, may give rise to claims against property owners who failed to correct or warn of hazardous conditions.

Workplace and industrial accidents frequently involve third-party liability, including equipment manufacturers, subcontractors, or site operators whose negligence contributed to the injury.

Proving Causation in Brain Injury Claims

One of the most contested issues in TBI litigation is causation. Defendants and insurers often argue that symptoms are preexisting, exaggerated, or unrelated to the incident. 

Causation disputes are common when symptoms worsen over time or when imaging findings are subtle. Law firms work with neurology and neuropsychology experts frequently demonstrate how traumatic forces produce lasting functional impairment even without dramatic radiographic findings.

Damages in Traumatic Brain Injury Cases

Traumatic brain injuries often result in substantial damages due to their long-term and life-altering nature.

Economic damages may include:

  • Emergency and hospital care
  • Neurology, imaging, and specialist treatment
  • Rehabilitation and therapy costs
  • Prescription medications
  • Lost wages and diminished earning capacity
  • Future medical and life-care expenses

Non-economic damages address the human impact of the injury, including:

  • Physical pain and chronic headaches
  • Cognitive impairment and memory loss
  • Emotional distress and psychological injury
  • Loss of enjoyment of life
  • Loss of consortium and strain on family relationships

In severe cases, damages may also account for permanent disability, loss of independence, and the need for long-term supervision or assistance.

What is the Deadline for a Traumatic Brain Injury Claims?

Under Texas law, most personal injury lawsuits, including those involving TBIs, are subject to a two-year statute of limitations. This deadline generally begins (or “runs”) on the date of the accident or injury-causing event.

Failing to file a claim within the applicable limitations period can permanently bar recovery, regardless of the severity of the brain injury or the strength of the evidence. While limited exceptions may apply in rare circumstances, relying on an exception is extremely risky.

Brain injury cases are particularly vulnerable to timing issues because symptoms may evolve slowly. Many individuals do not realize the seriousness of their condition until weeks or months after an accident. Despite this delayed onset, the legal clock usually continues to run. This is the reason we recommend a medical checkup immediately after serious crashes or other injuries.

Hire a Houston Traumatic Brain Injury Attorney

A traumatic brain injury is not just an isolated medical event. For many people, it marks the beginning of a long-term struggle with cognitive limitations, emotional changes, chronic pain, and reduced independence. These injuries affect families as much as they affect individuals.

If you or a loved one suffered a traumatic brain injury in Houston or the surrounding area, you need to contact an experienced personal injury attorney immediately. A properly handled claim can account for current treatment needs, future medical care, lost earning capacity, and the profound personal losses that can accompany a brain injury.

The Law Offices of Hilda Sibrian have served the Houston area for over 21 years. Our office serves Sugar Land, Missouri City, La Porte, Beaumont, Pasadena, The Woodlands, The Heights, Bellaire, Kingwood, Baytown and of course Houston proper.

Contact Hilda Sibrian today at 713-714-1414 or fill out our online contact form.

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