Car Accident Concussion: Why a Normal CT Scan Does Not Mean You Are Fine

The emergency room ran a scan, said it looked fine, and sent you home that night. Three weeks later you still get a headache by lunchtime, and you read the same email four times. Then the adjuster calls, says the scan was clean, and asks what you are claiming.

I represented insurance companies before I represented injured people, so I know what that call is doing. A clean scan is the first thing the other side reaches for, and it is the most misread piece of paper in a Florida car accident claim, because a head scan was never built to find a concussion. I handle brain injury cases in Florida and this comes up in nearly every one.

A normal CT scan does not mean you did not get a concussion. Doctors diagnose a concussion from your history and your exam, not from a picture, and in mild brain injuries only about 1 in 10 CT scans shows anything at all.

• A computed tomography (CT) scan looks for bleeding and broken bone, the things that need surgery tonight. Finding nothing is that scan doing its job.
• The damage in a mild brain injury is stretched and torn nerve fibers, and a regular scan cannot see those.
• You do not have to hit your head, and most people who get a concussion never black out.

Why this holds: StatPearls, on the National Institutes of Health Bookshelf, says plainly that "a normal head CT does not mean the patient has not suffered a concussion."

By the end you will know why your scan came back normal, whether you can get a concussion without hitting your head, what to watch for, how long this lasts, and how these cases get proven with no picture.

Key takeaways

• A clean scan rules out bleeding, not a concussion. Only about 1 in 10 CT scans finds a mild brain injury.
• You do not have to hit your head, and more than 9 in 10 people with a concussion never black out.
• Symptoms can start hours or days later, so being cleared at the scene settles nothing.
• Most people are better inside two weeks. Past three months it has a name: persistent post-concussion syndrome.

Why your scan came back normal

Because it was looking for something else. A head scan is an emergency tool, and the question it answers is whether you are bleeding inside your skull or have a broken bone pressing where it should not. Those need an operating room tonight. When the scan finds neither, that is good news.

You did not have to hit your head or black out

These are the two reasons people talk themselves out of going back, and both are wrong.

Start with the head strike. Your brain floats in fluid inside your skull. When the car stops hard your skull stops with it, but your brain keeps going and hits the inside of the bone, then rebounds and hits the other side. Doctors call that second hit the contrecoup injury, and StatPearls reports that the damage at the rebound site is worse than where the brain hit first. Your head never has to touch the headrest.

Then the blackout. People picture someone waking up on the pavement, so if they stayed awake they assume they are fine. StatPearls reports that more than 90 percent never lose consciousness.

What to watch for in the first days

The Centers for Disease Control and Prevention (CDC) splits these signs into what others see and what you feel. Ask whoever you live with, because some are easier to spot from outside.

• What they may notice: you seem dazed, you answer slowly, you are unsteady, or your mood seems off.
• What you may feel: headaches, dizziness, fog, trouble concentrating, sensitivity to light or noise, sleeping much more or less, and getting tearful over small things.

The CDC says some symptoms appear right away while others may not appear for hours or days. Go for emergency care now if you have a seizure, keep vomiting, have one pupil bigger than the other, slur your speech, feel weak or numb, get more confused, have a headache that keeps getting worse, or are hard to wake up.

How long does this last?

For most people, not long. StatPearls puts about 90 percent of concussion symptoms as temporary, clearing within 10 to 14 days. You are most likely on that path.

A smaller group is not. When symptoms carry on past three months, doctors call it persistent post-concussion syndrome. Past a year, another NIH Bookshelf review puts it at 10 to 15 percent, and says that number has been criticized.

4 things I tell people after a head injury

1. Go back to a doctor, even if the emergency room cleared you. That visit answered one question on one night. Your own doctor follows you over weeks.
2. Say every symptom out loud. People report the headache and skip the part where they lost their temper at work. The skipped ones show what the injury is really costing you.
3. Keep a short daily log. Two lines: how your head felt, and one thing that was harder than it should be.
4. Tell one person at home what to watch for. You are the worst judge of whether you seem like yourself, and getting hit again early is how a short recovery turns long.

How these cases get proven with no picture

This is the part the other side counts on you not knowing. With no scan to hold up, a brain injury is proven by building a record, and it starts the day of the crash, with what you said at the scene and what the nurses wrote down.

From there it needs three things. Neuropsychological testing, a long set of memory and attention tasks that measures what your brain is doing now instead of asking how you feel. A doctor who followed you for months and can say which direction you moved in. And the people around you, because a spouse describing what you cannot do anymore lands harder than anything you say about yourself.

Questions people ask me

The emergency room never said concussion. Does that sink my claim?

No, and it is common. Emergency rooms check for the dangerous things, and a concussion is often diagnosed later by a family doctor or neurologist, once symptoms have had time to show.

How much is a concussion claim worth?

There is no average, and anyone who gives you a number before reading your records is guessing. What moves it is the medical record, how long symptoms lasted, what testing showed, and what the injury cost you at work and at home.

What deadlines am I working against?

Two, and one is much shorter. Florida generally gives two years to bring a claim founded on negligence, under section 95.11 of the Florida Statutes. The deadline to be seen by a doctor comes far sooner, and we cover how long you have to see a doctor after an auto accident separately.

If the adjuster is pointing at your scan

Wolf & Pravato handles brain injury and car accident claims across Florida, from offices in Fort Lauderdale, Miami, West Palm Beach, Boynton Beach and Fort Myers. If you were cleared at the hospital and still do not feel like yourself, tell us what happened and we will tell you what your records should show.

This article is general information about brain injuries and Florida law. It is not medical advice and not legal advice about your situation. See a doctor about your symptoms, and speak with an attorney about your case.