Most people think of massive head trauma when they think of a head injury or concussion in regards to a car accident, but the fact is most head injuries do not even involve a direct blow to the head.

  • Concussion is a temporary state of altered consciousness (woozy, dizzy, seeing stars) but no loss of consciousness after a blow to the head or a rapid acceleration of the head, that usually resolves within a matter of weeks uncomplicated.
  • Post-Concussion Syndrome (PCS) is a concussion with symptoms lasting 3 mos or longer. (Some experts say 3 weeks, but by strict medical disability standards, 3 mos is the period of time required to consider a condition chronic)
  • Mild Traumatic Brain Injury (MTBI) is a loss of consciousness lasting 30 mins or less with or without amnesia due to a head trauma that has a Glasgow Coma scale score of 13-15.

Direct head trauma involves the head striking an object such as an airbag, the head restraint, door, window frame, sunroof frame, another occupant, etc. It is easy to see how a direct force to the head can create an injury to the brain.

Indirect trauma involves the brain being injured inside the skull vault by being quickly jolted front to back or side to side, but no frank direct trauma to the outer head. Three theories explain this mechanism: first, the brain is physically damaged by bouncing on the inner skull vault, second, the ligaments that tether the brain in the skull vault are overstretched by inertia and pulls on the tissue where it is affixed to the brain and third, the fluid nature of the brain causes a tidal wave like effect within the brain on impact causing damage to the brain tissue.


 You’re driving in the parking lot and a car suddenly pulls out in front of you and you cannot avoid it and hit them. Your head is jolted forward quickly. You see stars and feel a little woozy, but do not lose consciousness. You develop a headache that continues off and on for several days. Eventually, 2 weeks later you feel back to normal. This is a classic concussion.

Post-Concussion Syndrome

 You’re rear-ended in your car. You recall smacking your head on the head restraint and you immediately feel head pain and dizziness. Later you develop nausea and a stiff neck. Over the next few days your spouse notices you are spacing out and can’t concentrate well. You have trouble remembering things at work. You feel more emotional than usual and feel anger easily. After several months of treatment, your neck is better, but you occasionally have headaches and at stressful times you cant think as fast as usual. This is an example of post-concussion syndrome (PCS)

Mild Traumatic Brain Injury

 You’re walking in the mall and slip on water spilled on the tile and strike your head. Observers say you were unconscious for a minute or so before you were revived. You are taken to the hospital and have a CT scan (which is normal) and an examination. The ER doctor completes a form called the GCS and you score a 14. This is an illustration of a MTBI.

Of all these injuries, a concussion following a rear-impact car accident is the most common. Many accident victims do not even realize they have suffered a head injury because the symptoms may be very subtle and your doctor may miss the signs. Lingering headaches and loss of mental acuity after a car accident concussion is fairly common, but may not be diagnosed as PCS because non-specialist doctors do not recognize the symptoms as brain related and instead attribute the headaches to a neck or muscle problem.

After a car accident, your doctor should have you complete specialized questionnaires designed to uncover head injuries. If it’s an acute injury, the Glasgow Coma Scale (GCS) and/or Acute Concussion Evaluation (ACE) forms are the most common. If you were injured 1 week or longer prior to the exam, a Post-Concussion Syndrome Symptoms form is a commonly used tool.

Your doctor must then perform a specialized brain examination to uncover objective signs of brain malfunction.The exam will involve checking your reflexes, ability to sense light touch, pain and vibration stimuli, coordination of hands and feet and walking, eye movements and more.

After a comparison of the questionnaire and examination data, your doctor will then determine what type of injury you have suffered and order more tests if needed or set a plan for treatment.

If you’ve suffered a car accident, with or without actual force to the head and with or without headache, you must be evaluated properly.For more information and a Free Head Injury evaluation by Orange County Car Accident and Brain Injury Expert, Dr Barry Marks, go to: In addition, you should also hire the right car accident attorney so you will have someone or a professional who will guide you with all the processes and regulations related to the accident.


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