Recently I was preparing a settlement demand for a client who was involved in a high-speed, rollover motor vehicle crash. Not unexpectedly, his subsequent cervical MRI revealed a traumatic disc herniation. I noted however that the radiologist's report also mentioned a "cerebellar tonsillar ectopia" ("CTE") Upon further research I learned that this condition was a type of "chiari malformation" at the base of his brain. This finding is, in layman's terms, the downward movement of the cerebellum into the opening at the base of the skull and can cause serious neurological complications.
While chiari malformations can be congenital in origin and remain asymptomatic for many years, recent studies have shown that they can also be caused by the "whiplash-type" forces which are commonly experienced in motor vehicle accidents. In a 2010 study using both a recumbent and upright MRI, researchers examined 1200 cervical MRIs ( 600 from trauma patients, 600 from non-trauma patients) and identified cerebellar tonsillar ectopia in 9.8% and 23% of adults who had sustained motor-vehicle accident trauma versus 5.7% and 5.3% in the non-trauma sample. (Michael Freeman, Ph.D, et al. " A case control study of cerebellar tonsillar ectopia ( Chiari) and head/neck trauma (whiplash)", Brain Injury, Volume 24, Issue 7-8 (2010) Even if they are congenital and asymptomatic in nature, those same forces can aggravate the condition and render it symptomatic. Those symptoms include:
-dysphagia difficulty swallowing)
Surgery to decompress the pressure on the brain is the only available treatment for CTE's should they become symptomatic and typically involves the removal of bone at the base of the skull and/or cervical vertebrae. Like any diagnosed condition following a traumatic motor vehicle accident, insurance companies can be expected to claim that the condition was pre-existing and would have become symptomatic without the whiplash-type trauma caused by the crash. A detained review of the client's prior medical records coupled with expert testimony regarding causation will be necessary to rebut such claims.
At the Heyman Law Firm we have handled numerous traumatic brain injury cases and understand the toll that such injuries can have upon every facet of a crash victim and their family's life. Should you or a loved one have sustained such an injury, please contact us for a no-cost evaluation of your case.