A study by medical experts at a British university suggests that neuro inflammation, which occurs in people’s brains within minutes of suffering Traumatic Brain Injury (TBI), can facilitate neuro repair but can also contribute to secondary brain damage.

The research, by scientists at Birmingham University, has been focusing upon what is being described as the “golden hour” immediately after a head injury takes place when early identification of biomarkers can enable doctors to recognise and treat those patients most at risk of secondary injury while they are still capable of responding to therapy and before irreversible brain damage occurs.

The university’s TBI group, which carries out research linked with the activity of the National Institute for Health and Care Research (NIHR), is using ground breaking technologies to search for early signs of brain damage in patients before it becomes irreversible and to identify those patients most at risk of a poor cognitive outcome or of other mental health disorders. This not only allows the development of targeted and personalised treatment to suit individual patients, but can also be used to provide ongoing care for people most at risk of repeated TBI such as sports men and women, soldiers and the elderly.

The research programme, which involves a number of different academic disciplines including medicine, sports sciences, bioengineering, psychology, chemistry and computing,  is not the only research into TBI being carried out at Birmingham University. A team, led by Professor Antonio Belli at the University’s College of Medical and Dental Sciences, has identified inflammatory biomarkers which indicate whether the brain has suffered injury.

The team is trying to use them to develop a test that can be used on the side of a sports pitch or by paramedics to detect brain injury at the scene of an incident. Inflammatory markers are particularly suited for biomarker discovery because TBI leads to very early alterations in inflammatory proteins and this study has been funded by the National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre.

Dr Lisa Hill, of the University’s Institute of Inflammation and Ageing, said: “Early and correct diagnosis of traumatic brain injury is one of the most challenging aspects facing clinicians. Being able to detect compounds in the blood, which help to determine how severe a brain injury is, would be of great benefit to patients and aid in their treatment.”

A third study carried out at the university has found that patients with traumatic brain injuries face a high risk of suffering a stroke in the four months following injury and this remains significant for up to five years afterwards. This review, which brought together 18 studies from four countries, is the first of its kind to investigate post-injury stroke risk.

Funded by the National Institute for Health Research’s Surgical Reconstruction and Microbiology Research Centre based at University Hospitals Birmingham NHS Foundation Trust, the review showed that TBI patients have an 86% increased risk of stroke compared with patients who have not experienced a TBI.

Significantly, the findings suggest that TBI is a risk factor for stroke regardless of the severity or subtype of the injury. This is thought to be particularly noteworthy because 70% to 90% of TBI’s are mild and suggests that a TBI should be considered a chronic condition even if it is mild and the patient recovers well.

The researchers also found that the use of anti-coagulants, such as VKA’s and statins, could help to reduce stroke risk post-TBI, while the use of some classes of anti-depressants are associated with increased stroke risk post-TBI.

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Brain injuries can have profound and lasting effects on an individual’s physical, cognitive, and emotional well-being. One often overlooked consequence of brain injuries is their impact on the auditory and vestibular systems, which play a crucial role in maintaining balance, spatial orientation, and overall sensory perception. In this blog, we delve into the realm of audio vestibular treatment, shedding light on its significance in helping those with brain injuries regain control over their lives.

Understanding Audio Vestibular Treatment:

Audio vestibular treatment is a specialised therapeutic approach, that addresses issues related to hearing, balance, and spatial awareness. It encompasses a range of interventions aimed at mitigating the challenges faced by individuals who have sustained brain injuries. These treatments are designed to optimise the function of the auditory and vestibular systems, ultimately improving the quality of life for those affected.

Benefits of Audio Vestibular Treatment for Brain Injury Survivors:

1. Restoration of Balance:

Brain injuries can disrupt the delicate balance mechanisms within the inner ear, leading to dizziness, vertigo, and difficulties with coordination. Audio vestibular treatment employs a variety of exercises and techniques to retrain the brain and inner ear, facilitating the restoration of balance and reducing the risk of falls.

2. Enhanced Spatial Awareness:

Impaired spatial awareness is a common issue for brain injury survivors, leading to difficulties in navigating and interacting with the environment. Through targeted therapies, audio vestibular treatment helps individuals re-establish a stronger sense of spatial orientation, improving their ability to move confidently and independently.

3. Auditory Rehabilitation:

Brain injuries can affect auditory processing and lead to hearing problems. Audio vestibular treatment includes strategies to enhance auditory perception and processing, aiding in the interpretation of sounds and speech.

4. Reduced Sensory Overload:

Many brain injury survivors experience sensory overload, where normal stimuli become overwhelming. Audio vestibular treatment incorporates techniques to help individuals adapt to sensory stimuli, reducing distress and promoting emotional well-being.

5. Cognitive Benefits:

The auditory and vestibular systems are closely connected to cognitive functions such as attention, memory, and problem-solving. Audio vestibular treatment can indirectly enhance these cognitive abilities by optimising sensory inputs and their integration within the brain.

6. Improved Quality of Life:

By addressing the challenges posed by brain injuries, audio vestibular treatment empowers individuals to engage more fully in daily activities, participate in social interactions, and experience an improved overall quality of life.

Legal Considerations:

In cases where brain injuries have resulted from accidents or incidents caused by negligence or wrongdoing, individuals may be entitled to compensation. It’s essential to consult with experts who specialise in personal injury cases related to brain injuries. Coulthursts can help assess the circumstances, gather evidence, and navigate the legal process to ensure that brain injury survivors receive the support and compensation they deserve.

Audio vestibular treatment offers a ray of hope for individuals grappling with the aftermath of brain injuries. Its multidimensional approach, focusing on balance, spatial awareness, and auditory rehabilitation, can significantly enhance the lives of those affected. By understanding the importance of audio vestibular treatment and seeking appropriate legal assistance from Coulthursts, brain injury survivors can take crucial steps toward rebuilding their lives and securing a brighter future.

Author:  Karen Hayes who is a brain injury solicitor with more than 20 years’ experience.  Read more about Karen here

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Britain’s leading police officer for preventing road deaths believes that cyclists should wear head cameras to deter dangerous motorists because the evidence this would provide would enable the police to successfully prosecute lawbreakers threatening their safety.

Detective Chief Superintendent Andy Cox, formerly the most senior road safety officer with the Metropolitan Police and now the National Police Chiefs’ Council lead for fatal collision investigation reporting, said it would make cyclists what he called “part of the road danger solution” because police could not solve the problem on their own.

He made the announcement when he tried to raise awareness of the issue as he cycled 30 miles around central London with the campaigning BBC broadcaster, Jeremy Vine, who is well-known for recording near misses he has with motor vehicles while cycling to work in the capital[1].

His statement provides welcome support for all of us at Coulthursts as we are the leading brain injury lawyers specialising in winning compensation for people who have life changing Traumatic Brain Injury (TBI) issues. We have always made it clear that although not necessary for pursuing a claim for damages, the existence of head cam footage can greatly enhance the likelihood of a successful outcome.

It also comes at a time when the Government is actively pursuing a policy of encouraging more people to travel by cycle and on foot to enhance their health and well-being and as part of the fight against pollution and global warming.

It is aiming to make cycling and walking the preferred mode of transport for all journeys under five miles by 2040. At the same time, its framework, Active Travel England, envisages that half of all journeys in towns and cities will be walked or cycled by 2030.

The Government’s aspirations in this direction have been helped by the cycling converts who turned to self-power transport during the Covid lockdown as a legal way of escaping from the constraints of their homes and discovered that they rather liked the freedom of peddling down the open road.

The post-pandemic popularity of cycling is quite marked. In England, there were almost 6.5 million regular cyclists by 2021 – a rise of more than 28 per cent compared with five years previously.

Other parts of the United Kingdom also recorded increases, though of a rather more modest level. During roughly the same period, the percentage of people from all age groups in Scotland increased from 10.3 to 12.8 and in Northern Ireland from 12 per cent to 18 per cent. Respondents to a smaller sample in Wales revealed that 4 per cent of them cycled at least once a week for genuine travel purposes.

Government figures from 2014-16 showed that 9.5 per cent of adults each claimed to cycle at least 53 miles a year. By 2019-20, the average yearly distance travelled by each cyclist had increased to 88 miles per year.

In addition, the Government’s National Travel Survey showed that 47 per cent of people in England had access to a bike in 2020 and many of the new converts have remained as committed cyclists. This is supported by the fact that the UK spent £514 million on cycles during 2022 compared with only £390 million in 2018.

However, there is a downside. As cycling has increased in popularity, so have the accidents involving cyclists and they make bleak reading. Latest statistics show that more than 100 cyclists are killed and more than 4,000 are seriously injured every year, 56 per cent of cyclist fatalities occur on rural roads and the biggest single cause of cyclist casualties of all sorts is when they are wearing dark clothing and cannot be seen properly[2].

It is therefore a sobering thought that, according to The Brain Charity, 45% of British cyclists admitted to riding without a helmet even though wearing one could reduce the risk of brain injury. The body has now teamed up with a cycle gear manufacturer to draw attention to the danger[3].

Lightweight cameras are available for as little as £26 and it is also advisable to have  rear facing and forward facing cameras mounted on the cycle to catch shots which do not occur in an area where the cyclist does not happen to be looking at the time[4].

The matter has never been more important than it is now as the Government has been quick to latch onto new cycling converts as an important part of its drive towards a greener travel landscape.

Against such a background, there has never been a better time for cyclists wearing helmets and head cams to be as natural and common as motorists and their passengers wearing seatbelts.

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[1] https://www.standard.co.uk/news/uk/cyclists-wear-headcam-deter-dangerous-drivers-police-jeremy-vine-b1002004.html

[2] www.provizsports.com/en-gb/blog/uk-cycling-statistics/

[3] https://www.thebraincharity.org.uk/endura-bike-helmets-project-heid/

[4] www.cyclingweekly.com/group-tests/bike-helmet-cameras-327336#Cycling%20Safety%20Camera

Just click on the image above to find out more.

Concussion – or to give a more accurate description, a mild traumatic brain injury – can often go undetected or unreported for some considerable time, yet the possible long-term consequences can be devastating.

Following on from our informative blog on this subject, we have now produced an exclusive graphic of some of the vital signs to look out for if you think you, or someone you know, may be suffering from the effects of concussion.

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Coulthursts, The Brain Injury Lawyers, have further strengthened their top legal team with the arrival of Kevin Walker who has joined the firm as a Brain Injury Lawyer.

Kevin, who for 29 years has been handling large catastrophic injury claims of up to £10 million, brings a wealth of experience to Coulthursts which is the only law firm in the UK specialising entirely in helping people to rebuild their lives following the effects of a traumatic brain injury (TBI).

“Kevin has long had a special interest in brain injury cases, and is particularly excited about the groundbreaking way we help clients to rebuild their lives as quickly as possible by paying for the rehabilitation they need before we have settled their claims for damages,” says MD Philip Coulthurst.

“His past experience includes occupying a variety of very senior and niche legal roles, including managing a Serious and Catastrophic Injuries team, advising on complex workplace accidents, motorcycle accident claims, and assisting with claims relating to road traffic accidents here in the UK and in other countries. He will be a most helpful and resourceful addition to our team.”

Kevin adds: “I am delighted to be joining Coulthursts because their entire ethos so closely matches the specialised area of legal work to which I have devoted my working life.

“Few traumas are more destructive than TBIs which can blight not only the lives of those affected themselves, but also the families and loved ones who support them. Coulthursts’ system of funding the care they need, whilst at the same time pursuing their claim for damages, is wholly impressive and I am proud that I will now be a part of the company being able to offer its services to even more clients in need of this specialist help.”

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According to NHS inform, concussion is the “sudden but short-lived loss of mental function that occurs after a blow or other injury to the head”[1]. It adds that concussion is “the most common but least serious type of brain injury” and that “…the medical term for concussion is minor traumatic brain injury”.

So whilst a concussion is sometimes perceived to be an almost innocuous occurrence – the kind we usually associate with a sports field injury or an assault, or road traffic accident – the reality can be very different.

For, as indeed NHS inform attests to, a concussion is very much a traumatic brain injury. And even if ‘minor’ (or ‘mild’ as is the common term), the consequences can still be devastating for those that do not recover quickly.

Indeed, the effects of a concussion aren’t always immediately evident, and instead can gradually develop over time, with the person concerned not realising that they are suffering from it.

The signs are there but people often do not recognise them, particularly if they have been in an accident or incident, may be in pain and/or on medication. In fact, patients could be suffering from a range of over two dozen symptoms, including headaches, fatigue, poor memory, poor concentration, light sensitivity, sadness, anxiety, getting easily irritated, dizziness and even feeling worn out after a good night’s sleep.

And if their injury has been caused by a third party – for example, in the case of an accident, violence or even a fall – then it would also be advisable to seek legal advice from a specialist in cases involving Traumatic Brain Injury (TBI), and ideally with a speciality in concussion.

“Even though someone may have had a brain scan after an impact or violent shake to their head and no bleed has been found, they may still have suffered a concussion as concussions cannot be seen on a brain scan,“ explains Philip Coulthurst, MD of the specialist brain injury lawyers Coulthursts.

If you have been examined for concussion and your symptoms worsen, or if you later become aware of further symptoms – including those that make you feel nauseous or affect your thinking processes, or if you have worsening headaches, dizziness, problems with balance, slurred speech, loss of consciousness, sleepiness, weakness (and many other possible symptoms besides) – then you should return to A&E immediately. Note: You should have been given a head injury advice leaflet at A&E,  which among other things will advise you when you should return to A&E. It is important you follow the advice you have been given by any doctor.

Conversely, if you did not receive a head injury advice leaflet, then you should be able to find information online from the hospital you went to, but always err on the side of caution. You can also ring NHS 111 if you are unsure what to do and there are many useful sources of information to be found online, including this leaflet from Imperial College Healthcare NHS Trust – https://rb.gy/g1hwii

“Most people recover quickly from a concussion or head injury, but a significant minority, particularly those whose injury was severe enough to go to hospital, do not,” adds Coulthurst. “Often, they can go on to suffer ongoing persisting symptoms.”

A concussion is clinically known as a mild TBI, although in the UK the words concussion and head injury are more commonly used. In fact, around 90% of those attending A&E with a head injury are classified as a concussion or mild head injury.

“Most concussions occur without a loss of consciousness,” explains Coulthurst, “yet, for those who do not fully recover, this can be anything but mild and can affect a person’s day-to-day life, including their personal relationships and ability to work.”

Indeed, according to one study, it “…is becoming clear that ‘mild’ is indeed a misnomer for this disease, because many patients experience significant and persistent symptoms. For these patients, mild Traumatic Brain Injury [Concussion] is anything but mild.”[2]

“The challenge with this is that it can then be extremely difficult to access healthcare and treatment for those who suffer ongoing problems following a concussion,” concludes Coulthurst, “and treatment can often be limited to focusing on one symptom or issue such as headaches or emotional problems.”

“As part of our service when representing clients, we are often able to help secure access to the best treatment and rehabilitation for concussion, mild TBI and post-concussion syndrome, and our focus is to do this as soon as possible and often long before any claim is settled. This helps to ensure that the necessary treatment, which our clients would often struggle to secure any other way, is not only delivered, but also at the time they need it most.”

“So, if you, or someone you know, may still be suffering symptoms from a concussion or mild TBI, then please get in touch.”

[1] https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/concussion#:~:text=Concussion%20is%20the%20sudden%20but,is%20minor%20traumatic%20brain%20injury.

[2] McMahon et al 2014 – Symptomatology and Functional Outcome in mTBI: Results from the prospective TRACK_TBI Study

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Nearly half of all Traumatic Brain Injuries (TBIs) are believed to be caused by road traffic accidents (RTAs). With RTAs being the most common cause of TBI in the young. But many of those injured are unaware they may have a case for support and compensation. What can be done to ensure injured parties get the support they need?

According to the best estimates available, some 1.4 million people attend A&E at hospitals every year with a Head Injury, and 160,000 of those then go on to be admitted to hospital. However, a significant proportion of people who sustain a TBI or Head Injury in a road traffic accident are thought to be missing out on compensation to which they are entitled, simply because they do not think they have a case.

The casualties slipping through the net include those who are partly at fault for the accident in which they were involved, or who are related to the person at fault. Others who mistakenly think they cannot make a claim, are those injured by a driver not subsequently prosecuted by the police, or who were in a crash with an uninsured driver or unknown driver. The injured party in all these scenarios could still be entitled to compensation to help them rebuild their lives.

According to the RAC Foundation, by September last year there were 40.8 million licensed vehicles on the UK’s roads, including 33.2 million cars, 4.1 million vans, 1.5 million motorcyles, 500,000 HGVs, and 150,000 buses and coaches. On top of this there are also an unknown number of bicycles and, of course, pedestrians. With all these different users sharing our crowded roads, it is therefore unsurprising that accidents happen.

In fact, someone is killed or seriously injured on UK roads every 16 minutes, and there are thought to be several reasons why road traffic accident (RTA) rates remain consistently high:

• The driver or rider failing to look properly (37%)
• The driver or rider failing to judge the other person’s path or speed (19%)
• The driver or rider acting recklessly, hurried driving or speeding (16%)
• A poor turn or manoeuvre (12%)
• Loss of control (11%)

And whilst there have been considerable advances in vehicle technology, the likelihood of head injuries at speeds in excess of 10 mph remains high.

A TBI is usually caused by an impact to the head. This external force can cause a focal injury to the brain. An impact to the head, or if the head is violently shaken without any impact, can also cause what is known as an acceleration/deceleration injury. This is where there is a sudden violent movement of the head causing the brain to move and rotate inside the skull. These can cause bruising (contusion) to the brain and trauma to the blood vessels causing bleeding (hematoma or haemorrhage). Contusions and Bleeds will usually be seen on head scans; however, an acceleration/deceleration injury can cause the shearing or stretching of the nerve fibres (axons) inside the brain which are microscopic and unlikely to be visible on a brain scan.

Concussions and those labelled a ‘mild head injury’ are also unlikely to be seen on any scan but can cause ongoing symptoms for some which can have significant consequences– see our blog on concussion.

The risk of TBI also depends on road user type (i.e. car, motorbike, bicycle or pedestrian), the speed of impact and the direction of impact. The higher the speed, the greater the impact on the skull and the brain. Research has shown that the risk of brain injury triples when the impact velocity is doubled.

Brain injury is also more likely in cars involved in side impacts, or where the change of speed is greater, like during a head-on collision. It is also more likely in vulnerable road users, especially where no head protection is worn, with pedestrians and cyclists six times more likely than car occupants to suffer moderate to severe brain injury on the roads.

The Office for National Statistics also gives us the following information relating to non-car road traffic accidents:

• Pedestrians – there are more than 700 pedestrian deaths, and 7,000 injuries annually
• Motorbikes – there are more than 600 motorbike deaths and almost 7,000 injuries annually
• Cycling – there are approximately 120 deaths and more than 2,000 injuries annually

Sadly, suffering from a TBI can be life changing, even if initially considered to be on the ‘mild’ end of the scale. It is therefore crucial to seek out specialist legal advice as soon as possible, even if you fear you may not have a case for compensation.

At Coulthursts, we are unique as a law firm in that we provide a joint legal and rehabilitation approach. We can pay for and coordinate treatment and rehabilitation at the earliest opportunity, to give our clients the best chance of making the best and quickest recovery from their brain injury. At the same time, we deal with the legal claim and fight to obtain the best possible compensation. We also pride ourselves in providing support to the whole family and not just the injured individual.

Please do not hesitate to contact us to discuss your accident at no cost or obligation.

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Karen Hayes has joined Coulthursts in the role of Brain Injury Solicitor.

Attracted by Coulthursts’ position as the UK’s only law firm dedicated entirely to providing legal  services for people recovering from traumatic brain injuries (TBIs)  – as well as the company’s new and innovative way of helping clients by funding rehabilitation up front before any settlement is reached – Karen brings with her more than 20 years’ experience in the area of personal injury.

“Karen has a long track record in working with a wide range of clients, including those with traumatic brain injuries (TBIs), spinal cord injuries, serious orthopaedic injuries and amputations,” explains MD Philip Coulthurst.

“She has demonstrated a clear passion for supporting clients with life-changing injuries throughout her career and, as such, she will be a great addition to the Coulthursts team as we focus on our position as the UK’s only law firm dedicated entirely to providing legal services for TBI claimants.

“We wish Karen every success in her new role at the heart of the Coulthursts team.”

Karen adds: “Traumatic Brain Injuries impact every aspect of life, not only of the individual involved but of their families, too, so this is a unique opportunity for me to deliver the best possible outcome for clients and their families.

“I have been impressed with Coulthursts’ commitment to supporting clients at every stage of their recovery, and I am looking forward to working in this new and unique way.”

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Many people think there is little they can do in terms of making a claim for compensation if they or a loved one is the victim of a Hit & Run road traffic incident. But the good news is, there is still much you can do to pursue a claim, even if the vehicle and driver are never identified, or they turn out to be uninsured. Brain injury lawyer Kirsty Mors explains more…

According to the latest government statistics on reported road casualties in Great Britain, more than 27,000 people suffered serious injuries on the UK’s roads in 2021, with another 100,000 suffering less severe injuries.

These only account for the incidents that have been reported to the police, the numbers are therefore likely to be a lot higher. In fact, up to half of all brain injuries are estimated to occur on the road. We don’t know exactly how many of these were as a result of a Hit & Run incident, but we do know it’s likely that in a high percentage of such incidents the drivers and vehicles were never identified.

As a result, for anyone affected by such an incident (including their families and loved ones), it can feel like nothing can be done with regards to pursuing a claim for compensation. After all, how do you pursue a claim against an unidentified driver?

But thanks to the creation of the Motor Insurers Bureau (MIB) in 1946 – a not-for-profit organisation funded by the UK insurance industry to protect victims of accidents caused by uninsured and untraced drivers – help is at hand. Through its Untraced Drivers Agreement, the MIB deals with more than 15,000 Hit & Run claims every year where the driver has never been identified.

There is therefore much that can be done to help anyone who has suffered a Traumatic Brain Injury (TBI) to get the help and support they need. Here is our advice to anyone who thinks they – or someone they know – may have a claim:

• Get as much information as you can at the scene of the accident – witness details, statements, camera footage
• Try to take down the make, model, colour and registration of the vehicle (or vehicles involved)
• Always report the incident to the police as soon as possible, this should be within 14 days unless of the incident unless you have a good reason not to
• Seek medical attention, either immediately or as soon as possible after the incident. The MIB will require evidence that you have sustained an injury, so having this documented by a medical professional as early as possible is helpful
• Take photographs of any damage to your vehicle (if you are in a position to do so)
• Notify your insurer (if you have one) but don’t rush into accepting your own insurer’s legal advice… always opt for a specialist who has exacting knowledge and experience of dealing with cases involving your specific injuries

We approach any claim under the MIB scheme in the same way that we would if it were a claim directly against a motor insurer. The MIB essentially acts as the defendant and it is still for the injured person to prove that they should receive compensation, and the level of compensation that they should receive, which is where we can help.

At Coulthursts, we have specific experience of successfully pursuing claims against the MIB and we always have the same end goal in mind – to secure the level of compensation that truly reflects the often devastating, long-term effects of being injured by an unknown, or uninsured, Hit & Run driver.

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Karl Welborn, Consultant Occupational Therapist and Company Director of Well Way Rehab Solutions, explains:

Coulthursts contacted me about a young client who had been badly injured in a car accident while driving. He had been in hospital for a month and the hospital wanted to discharge him. Coulthursts contacted me to see if I could contact the discharge coordinator and help with the discharge planning and immediate rehabilitation. I therefore spoke with the discharge team at the hospital and also spoke to the client’s wife.  

As well as suffering a brain injury, he had a fracture to his right clavicle, a complex facture to the ulna and radius on his right side and fractures to his right and left tibias. It was recommended that he could not be weight bearing for at least ten weeks and it might be longer. We had to arrange for him to be discharged to his home with a bed downstairs and the use of a wheelchair and the challenge was how to make it a smooth and seamless transition.

He had been a strong, muscular man who was the main provider for his wife and one year-old son, but he had become very weak, had lost over one-and-a-half stones in weight and was not eating. He was also stressed and panicked and, while in hospital, had been in a state of post traumatic amnesia and did not know where he was, for some time following the accident.

My holistic assessment of him was physical, psychological and cognitive and it was important to ascertain what his needs were and what we needed to get in for him, that would allow him to function within his home safely and proficiently, as well as his access to community requirements. I found out that he was experiencing sensory changes to his legs and arm, that he was worried and depressed about the future and that he was struggling to retain information. He also sometimes used expletives which he would never have done before and sometimes discussed things which he did not realise were upsetting to other people.

He was also very tired all the time. He thought that this was caused by being in hospital and that it would get better at home after his discharge, but it didn’t. He had cognitive and emotional fatigue and that took away a lot of his energy, which can be a sign of brain damage. He needed therapy to improve his range of movement, to improve his strength and to improve his range of movement in his lower and upper limbs as well as in his core stability. We therefore gave him exercises he could do while lying down and sitting.

I needed a rehabilitation assistant to make sure he was doing these exercises and the client also needed two transfer boards to help him transfer from bed to wheelchair and wheelchair to toilet and back again.  I recommended a foot spa to improve his circulation and to help with the personal hygiene of his feet and he needed a bath board and a higher seat for the toilet. I sent a list of these things to Coulthursts who immediately purchased the equipment.

At around the same time the weather was improving, so when his wife took their child out for a walk, he understandably wanted to go with them. Thanks to Coulthursts support we were able to hire an electric wheelchair which really helped his mental health. So much so, in fact, that he no longer felt worthless and felt he was fulfilling his role as a father.

We are also working out his fatigue management package so he can make his energy function and recharge his battery during the week.

Meanwhile, our physios have been getting him out to the gym and into the pool, but he still struggles to retain information. A joint gym membership was arranged for him and his wife. You can see that he has broken legs but you cannot see what he is thinking, so we talk about this. He has ongoing problems and we are working out ways of tackling this.

With our rehabilitation programme, he has made so much progress that he can now walk for 2 miles a few times a week and he is now able to get up the stairs.  He has advanced this far because Coulthursts have provided the funding that has made it possible. In contrast, all that was available for him on the NHS was one therapy session of 30 minutes once a week.

He says that he is still not the person he was and there are things he will have to live with all his life. There are his fatigue and his memory problems, and he will never have the same physical status and will likely be limited in how he can work.

We have set a number of goals, namely improving his posture, cognitive behaviour, optimising hand dexterity, maintaining lower limb use and improving power, managing his fatigue and enhancing his mental health with the ultimate goals being returning to a vocation and returning to driving again.

This case is unique because of the way Coulthursts have provided the resources for it. They agreed with my recommendations without any delay, arranged funding and for any equipment and for other items such as the gym membership.  It is a really positive outcome and I have never had a case quite like it before.

Philip Coulthurst, Managing Partner at Coulthursts, The Brain Injury Lawyers, replies:

Enabling the recovery of our clients is always our first priority.

Long before any legal settlement is reached on their behalf, we know how important it is to support our clients’ rehabilitation first and foremost.

It’s why we already work with some of – and aim to work with even more of – the UK’s leading charities and neurorehabilitation treatment centres in our specialist legal field of traumatic brain injury.

And it’s why cases such as the one outlined by Karl above are so important to us, a company wholly focused on working with individuals and their families after a brain injury.

About the Authors:

Karl Welborn graduated from Coventry University with a first-class degree with honours in Occupational Therapy. He has since studied at master’s level in the field of leadership and innovation and Injection Therapy (Neurology). He has over 20 years of dynamic experience working in healthcare and is the Director and Consultant Lead Occupational Therapist for Well Way Rehabilitation Solutions. Karl has great knowledge of working in the National Health Service where he was clinical lead for Occupational Therapy in the hyper-acute, acute and community stroke, neurology and complex rehabilitation services.

Philip Coulthurst has more than 20 years’ experience as a solicitor, with a specialty in brain Injury. Philip is committed to taking a genuine, client-centric approach to working with people who have life-changing injuries. Philip regularly delivers training and lectures on traumatic brain injuries, encompassing neuroscience, epidemiology and socioeconomic effects and the need for better, integrated care pathways. He is a Member of the British Neuroscience Association, the Federation of European Neuroscience Societies and the Association of Personal Injury Lawyers. Philip has graduated from an Accelerated Leadership course at Harvard Law School.

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