On this episode of Mind Matters: Navigating Head Injuries and Concussions, host Kiley Como sits down with Dr. Jeremy Hertza of Neurobehavioral Associates in Augusta, Georgia, to unravel one of the most misunderstood topics in personal injury law: traumatic brain injuries (TBIs) and concussions.
Understanding the Invisible Injury
When most people hear “brain injury,” they picture MRIs, CT scans, and dramatic symptoms. But as Dr. Hertza explains, concussions are often invisible on traditional scans—and that doesn’t make them any less real.
In fact, one of the first myths Dr. Hertza debunks is that you must lose consciousness to have a concussion. “You don’t have to black out,” he says. “Even a brief disorientation or memory loss—called retrograde or anterograde amnesia—can signal a serious brain injury.”
He likens the brain’s trauma response to a survival mechanism. “When trauma hits, your body redirects oxygen away from the brain to your muscles,” he explains. “It’s not worried about forming memories—it’s just trying to keep you alive.”
Why MRI Results Often Miss the Mark
One of the most frustrating parts of a TBI case is when a client’s MRI comes back “normal.” Dr. Hertza warns against relying on these results.
“Concussions don’t show up on MRIs. The damage is functional, not structural,” he says. “It’s not about whether you can see it—it’s about how it affects you.”
That’s where neuropsychological testing comes in.
What Is a Neuropsychological Exam?
Dr. Hertza breaks it down into four main components:
- Detailed History & Interview: Gathering accident facts, symptoms, prior conditions, medications, sleep issues, and more.
- Neurobehavioral Observation: Watching patients over 4–5 hours to assess how their brains function under stress and fatigue—not just in short bursts like with a quick screener.
- Formal Brain Mapping Tests: These evaluate how different areas of the brain are functioning, including attention, memory, language, and processing speed.
- Clinical Interpretation: Perhaps most importantly, Dr. Hertza connects the dots: what’s from the accident, what’s pre-existing, and what’s from medications or other factors.
“This is where we shine,” he explains. “We can tell if someone’s struggles are from their ADHD, sleep apnea, past stroke—or from the crash.”
Real-Life Examples That Matter in Court
In one case, Dr. Hertza evaluated a man who had a prior frontal lobe stroke years before a wreck. Of the three people in the vehicle, he was the only one seriously impaired afterward. Why? “His brain was already weakened,” Dr. Hertza explains. “So when the crash happened, it couldn’t fight back the same way.”
In another case, a man was hit by a semi after trying to avoid a stalled car. Using Diffusion Tensor Imaging (DTI), Dr. Hertza and his team were able to see the white matter shearing in the frontal lobe—a direct match to the cognitive symptoms found in testing.
The Clock Is Ticking: Why Early Treatment Matters
Brain recovery has two stages:
- Stage 1 (up to 2 years): The brain tries to repair the damage—“fill the pothole,” as Dr. Hertza puts it.
- Stage 2 (after 2 years): If repair isn’t possible, it has to build a “detour”—a less efficient route to function.
The first 9–14 days post-concussion are especially critical. “That’s when your brain is most vulnerable,” Dr. Hertza warns. “If a second injury happens during that time, the consequences can be devastating.”
The Lasting Symptoms You Might Overlook
Legal teams and families should be on the lookout for:
- Slowed thinking or “brain fog”
- Attention and memory issues
- Emotional outbursts that seem out of proportion
- Difficulty organizing thoughts or staying on task
These issues are often subtle at first and don’t emerge until weeks or even months later, once the initial pain starts to subside.
Final Thoughts: It’s Never Too Late
Even if a client comes in months—or years—after the injury, Dr. Hertza emphasizes that support, rehabilitation, and testing still matter.
“There’s always hope,” he says. “We’re not just here to explain injuries to a jury—we’re here to help people live the best lives they can after brain trauma.”
Need Help After a Brain Injury?
At Shane Smith Law, we understand how hard it is to prove what you can’t see. That’s why we partner with experts like Dr. Hertza—to fight for the full picture of what you’re going through.
In pain, call Shane! 980–999–9999
Subscribe to the Mind Matters podcast for more interviews like this—and don’t forget to check out Part 2 of our conversation with Dr. Jeremy Hertza.
