This animation may only be used in support of a single legal proceeding and for no other purpose. Read our License Agreement for details. To license this image for other purposes, click here.
MEDICAL ANIMATION TRANSCRIPT: The brain is the most complex part of the human body. This three-pound organ is the seat of intelligence, database of memories, interpreter of the senses, and the director of all movement. Lying in its bony shell and washed by protective fluid, the brain is also the most fragile organ in the body, with the same texture and consistency as gelatin. Within the brain are over 100 billion nerve cells, called neurons, sending electrical and chemical signals to and from the body. Each neuron has a cell body, a long nerve fiber called an axon, and projections of the cell body called dendrites. Dendrites extend out from the cell body to receive messages from other nerve cells. Axons in the brain connect neurons with each other, which in turn provide extensive interconnections with other brain areas. Because the brain and its nerve cells are so fragile, sudden rapid movements of the head can cause injuries. During one such injury, called coup-contrecoup or acceleration-deceleration injury, the brain bounces back and forth against the bony interior wall of the skull. In high-speed coup-contrecoup injuries, the impact may be violent enough to cause swelling and bruising of the brain tissue called a contusion. However, in cases involving low-speed coup-contrecoup injuries, the resulting damage may not be visible to the naked eye. As the brain moves back and forth within the skull, areas of varying density in the brain slide over each other at different speeds. Axons crossing these junctions experience tremendous shearing forces, causing them to stretch and tear from the cell body. This event is called axonal shearing or diffuse axonal injury. Brain damage can continue to occur for hours or days after the initial injury. Damage to the axons can lead to a breakdown of communication among neurons in the brain. The torn axons quickly degenerate, releasing toxic levels of chemicals called neurotransmitters into the extracellular space. In turn, many of the surrounding neurons begin to die over the next 24 to 48 hours, worsening the initial effects of the injury. Mild to moderate cases of diffuse axonal injury, or DAI, may result in symptoms such as brief loss of consciousness, impaired long-term memory, reduced problem-solving ability, lower social inhibition, and problems with attention and perception. Severe cases of diffuse axonal injury may result in a coma or a persistent vegetative state. In the United States, over 1 million cases of mild traumatic brain injuries, including diffuse axonal injury, are reported each year. Of this number, over 300,000 patients suffer long-term effects from the damage. Computed tomography, or CT, and magnetic resonance imaging, or MRI, are tests that can be performed to check for mild traumatic brain injury. The results of these tests usually show a normal reading. Therefore, doctors must rely on patient history and a clinical exam to diagnose mild traumatic brain injury.
"I wanted to thank you for the terrific job you did illustrating my client's
injuries. The case was settled at the pre-suit mediation, and I believe a
good part of the success we had was due to the medical legal art you
prepared.
Your work received the ultimate compliment at the conclusion of the mediation. The hospital risk manager took the exhibit with them at the
conclusion of mediation, and will be using it to train nurses on how to
prevent bed sores..."
Steven G. Koeppel Troy, Yeslow & Koeppel, P.A. Fort Myers, FL
"Medical illustrations are essential during trial for any medical malpractice case. The people at MLA have the uncanny ability of creating medical illustrations that simplify the most complex of medical concepts and human anatomy to a lay audience. The exhibits of MLA allow experts to easily describe complex concepts and human anatomy in a manner that could
not be done otherwise.
In addition, their custom illustrations show in great detail the extent of
injuries suffered and the devastating effects they have had on the client's
anatomy. These custom illustration can show, side by side, the body before
and after a catastrophic injury. The effect of this juxtaposition is
unmatched by any testimony that can be adduced at the time of trial.
Even jurors after trial have commented on the ease with which they grasp
medical concepts and anatomy once the MLA exhibits were introduced and
used by my experts. Even judges who have "seen it all" are thoroughly
impressed by the detail and sophistication of the illustrations.
"I wanted to take some time out to let you know what a wonderful job you did
with the 'collapsed lung/fractured rib' illustrations. They were both
detailed and accurate. My medical expert was comfortable working with them
and he spent at least an hour explaining to the jury the anatomy of the
lungs, the ribs and the injuries depicted in the illustrations. Needless to
say, the jury was riveted to the doctor during his testimony.
The jury returned a verdict for $800,000.00 and I'm sure we would not have
done so well if not for the visualizations we were able to put forth with
your assistance. Lastly, my special thanks to Alice [Senior Medical
Illustrator] who stayed late on Friday night and patiently dealt with my
last minute revisions."
Daniel J. Costello
Proner & Proner
New York, NY
"The Doe Report's Do-It-Yourself Exhibits program enables easy customization
of complex medical exhibits at a reasonable expense and in a timely manner.
Practically speaking, custom medical exhibits are no longer an unthinkable
luxury, but a routine necessity."
Jack S. Cohen
Levy, Angstreich, Finney, Baldante & Coren
Philadelphia, PA
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.