The hardest injuries to prove are the ones nobody can see. A brain injury doesn’t show up in a cast or a scar. It shows up as a person who can’t hold a thought, loses their temper over nothing, can’t tolerate a grocery store, and keeps being told the CT scan was normal. If that’s what’s happening in your house since the crash, don’t take a normal scan as the last word.
The short answer
A concussion is a traumatic brain injury. Doctors classify it as a mild TBI, and “mild” describes how it presented at first, not how much it can change your life. You do not have to lose consciousness, and you do not have to hit your head; the brain can be injured by acceleration and deceleration alone. A normal CT scan does not rule it out. Proving one takes early documentation, the right specialists, and often neuropsychological testing.
Get emergency care for these signs
Some symptoms after a head injury are medical emergencies. Go to an emergency room or call 911 for a headache that keeps getting worse, repeated vomiting, a seizure, unequal pupil size, slurred speech, weakness or numbness on one side, increasing confusion or agitation, clear fluid from the nose or ears, or someone who can’t be woken. This page is about the legal side; nothing here is medical advice, and if any of that is happening, get help now rather than reading further.
You don’t have to hit your head
The brain floats in fluid inside the skull. When a vehicle stops abruptly, the brain keeps moving, strikes the inside of the skull, and can rebound and strike the opposite side, a coup-contrecoup injury. The rotational forces in that instant stretch and shear microscopic nerve fibers. That’s diffuse axonal injury, and it can happen with no external wound at all, which is why “there’s no bump on his head” proves nothing.
What symptoms look like in real life
The clinical list (headaches, dizziness, light and noise sensitivity, blurred vision, nausea, fatigue, trouble concentrating, memory problems, slowed thinking, irritability, anxiety, depression, personality changes, and sleep disruption) doesn’t capture how this actually presents. It looks like re-reading the same email four times. Snapping at your kids and not knowing why. Getting lost driving a familiar route. Sitting in a meeting unable to follow it. Being exhausted by noon. Families notice this long before the injured person does, which is why the family’s observations are some of the most valuable evidence in the case.
Why the imaging “looks fine”
A CT scan in the ER is looking for bleeding, swelling, and skull fracture, things that need surgery tonight. It is not designed to detect the microscopic axonal damage that causes most post-concussive symptoms. A normal CT means you’re not bleeding into your skull. It does not mean your brain wasn’t injured, and an adjuster who conflates the two is either mistaken or hoping you are.
What does help build the picture: MRI where clinically indicated, referral to a neurologist or a physician specializing in concussion or brain injury rehabilitation, formal neuropsychological testing (a battery of standardized measures of memory, attention, processing speed, and executive function that produces objective, comparable data), vestibular and vision therapy evaluations, and speech-language pathology assessment for word-finding and processing problems.
How to document what’s happening
Tell every provider about every cognitive and emotional symptom, not just the headaches. People systematically under-report the mental and mood symptoms because they feel embarrassing or unrelated, and what isn’t in the chart didn’t happen, as far as an insurer is concerned. Keep a simple daily journal of symptoms, and have your spouse, a parent, a close friend, and a supervisor write down what they’ve noticed changed since the crash, in their own words. Work records showing dropped performance, missed days, or a change in duties are powerful. So are before-and-after comparisons: what you managed easily last year and can’t manage now.
Getting evaluated quickly also matters enormously for causation. See why the date of your first medical visit is so important.
How a brain injury changes the value of a claim
These are frequently the most valuable cases and the most under-settled ones, because the losses go far beyond the medical bills. A TBI claim considers past and future medical and rehabilitation care, lost income and (often the largest single component) lost earning capacity where someone can no longer do the work they trained for, the cost of ongoing care and support, and the non-economic harm: the pain, the mental anguish, and what’s been taken from how you live. In an ordinary Texas motor-vehicle negligence case there is no cap on non-economic damages; the well-known caps apply to medical malpractice (§ 74.301) and to claims against governmental units (§ 101.023). Our page on what your car accident case is worth and how pain and suffering is calculated go deeper.
These cases usually need expert support (a life care planner and often an economist) to put a defensible number on decades of future need. That work takes time, which is another reason not to settle early.
Paying for the workup
Neuropsychological testing and specialist care are expensive, and they often come before any settlement. PIP and MedPay pay regardless of fault (PIP vs. MedPay), health insurance covers the larger care, and some specialists will treat on a letter of protection. See who pays medical bills after a Texas car accident.
The deadline
Texas generally gives you two years from the date of the crash to file a personal-injury lawsuit (Texas Civil Practice & Remedies Code § 16.003), and claims against a governmental entity carry much shorter notice deadlines. Because a brain injury case needs a fully developed medical and vocational record, two years is less runway than it sounds like.
Frequently asked questions
Is a concussion a traumatic brain injury?
Yes. A concussion is classified as a mild traumatic brain injury. “Mild” refers to how the injury presented initially. It doesn’t describe how serious or lasting the effects can be.
Can I have a brain injury if my CT scan was normal?
Yes. CT scans detect bleeding and swelling. They’ll catch fractures too, but they aren’t designed to show the microscopic axonal damage behind most post-concussive symptoms. Diagnosis often relies on clinical evaluation and neuropsychological testing. An MRI helps where it’s indicated.
Do I have to hit my head to have a TBI?
No. Rapid acceleration and deceleration can move the brain within the skull and shear nerve fibers without any impact to the head at all.
How do you prove a mild traumatic brain injury?
With prompt evaluation and consistent specialist care. With neuropsychological testing that objectively measures memory and attention, plus processing speed. Contemporaneous symptom records help. So do statements from family and coworkers about observed changes, and work records showing altered performance.
How long do concussion symptoms last?
Many people improve within weeks, but a meaningful number have symptoms lasting months or longer, sometimes called persistent post-concussive symptoms. Because the trajectory is unpredictable early, settling before your specialists know where you’re headed is risky.
Something’s not right since the crash?
If you or someone you love hasn’t been the same since a Houston car accident, call Blass Law at (713) 664-4000 or request a free case evaluation. Brain injury cases are won on documentation that has to start early. See also our Houston car accident lawyer page.
Reviewed by Jay Blass Cohen, founder of Blass Law PLLC, ACS-CHAL Forensic Lawyer-Scientist, certified Drug Recognition Expert, and SFST instructor, serving Houston since 2009. This article is general information, not legal or medical advice for your situation. Prior results do not guarantee a similar outcome.