If you are reading this, there is a good chance something like this has happened in your family. Someone you love took a hard fall, was in a car crash, or came off an amusement park ride, and seemed fine. No cuts, no bruises. Maybe the emergency room did a scan and sent them home. But since then, something has been wrong. The headaches will not go away. They are tired, foggy, short-tempered, forgetful. They are not quite themselves — and nobody can show you why.
You are not imagining it, and you are not alone. Tobin Lanzetta has spent more than 20 years representing people with brain injuries and their families, and this is the story we hear again and again. Some of the most serious brain injuries leave no mark on the outside at all.
YOU DO NOT HAVE TO HIT YOUR HEAD TO HURT YOUR BRAIN
The brain is soft, and it sits inside a hard skull. When the head is whipped or twisted suddenly, the brain moves and twists inside it. That motion alone can stretch and damage the brain's delicate wiring and the small veins on its surface. The head does not have to strike anything.
Doctors and scientists have known this for more than forty years. The Centers for Disease Control and Prevention includes a "jolt" to the head — not just a bump or a blow — in its definition of what causes a traumatic brain injury. And research going back to the 1980s found that the people with this kind of twisting injury were actually less likely to have a skull fracture or visible bruising of the brain. The injury caused by motion is the one least likely to show.
HOW IT HAPPENS
In a fall. Falls put more people in the hospital with a brain injury than anything else — nearly half of all brain-injury hospitalizations, according to the CDC. It can be a slip on a wet floor, a trip on broken pavement, a stairway with a loose rail or bad lighting, a ladder or scaffold that gives way, or a fall from playground, gym, or sports equipment that was defective or poorly maintained. When the body hits the ground, the head whips and twists, whether the person lands on their head, their back, or their hands. The fall may look minor. The injury may not be.
In a car crash. A seat belt holds your body in place. Nothing holds your head. In a rear-end collision, a side impact, or a rollover, the head snaps and twists on the neck. A person can be told they "just have whiplash," never lose consciousness, never touch the window or the steering wheel — and still have a brain injury.
On an amusement ride. A roller coaster is a machine designed to move the human body around at high speed, and how well it supports and controls the rider's head matters a great deal. Doctors have published repeated reports of riders who developed bleeding around the brain after roller coaster rides, including healthy young people. In one published case, a 34-year-old woman had a normal CT scan three days after a day of riding coasters. Four weeks later, an MRI found bleeding on both sides of her brain.
The other side says the forces on these rides are too low to hurt anyone. But there are many incidents, verdicts, and settlements saying the exact opposite.
In sports and other sudden jolts. A collision between players, a piece of equipment that fails, anything that whips or spins the head can do the same thing.
WHY THE MEDICAL SYSTEM
CAN MISS IT
This is the part families find hardest, so it is worth saying plainly: these injuries are missed often. Usually that is not because anyone failed to care. It is because of how emergency care is set up — and it is not your fault for not catching it sooner.
The emergency room is built for emergencies. Its job is to find the injuries that are immediately life-threatening and treat them fast. With no wound, no broken bone, and a patient who is awake and talking, the system has done what it was designed to do, and the patient goes home.
The standard test cannot see this kind of injury. A CT scan is the workhorse of emergency care, and it is very good at finding large bleeds and fractures. It cannot see stretched or torn nerve fibers. In one large study of more than 1,000 people with a "mild" brain injury and a normal CT scan, 38 percent had not fully recovered. A normal CT means there was no emergency that day. It does not mean there was no injury.
The symptoms show up after the visit is over. The CDC warns that symptoms can change over time, and some are not noticed for days or longer — often when the person tries to go back to work or school. By then the emergency room visit is long finished, and it is easy for no one to connect the new problems to the injury.
The label says "mild." The system classifies a brain injury as "mild" based on how alert the person is in the emergency room, not on what happens to their life afterward. That label then follows them through every record and every claim file. In a major U.S. study of more than 1,100 people with a "mild" brain injury, more than half were still having problems in daily life a year later.
WHEN TO GET HELP RIGHT AWAY
After a fall, a crash, a rough ride, or any hard jolt, the CDC says to call 911 or go to the emergency room for any of these:
A headache that keeps getting worse
Repeated vomiting
Weakness, numbness, or poor coordination
Slurred speech or unusual behavior
One pupil larger than the other
A seizure
Growing confusion, restlessness, or agitation
Passing out, extreme drowsiness, or being hard to wake
Quieter symptoms deserve attention too: trouble concentrating or remembering, sensitivity to light or noise, dizziness, trouble sleeping, irritability, or a family's sense that "something is different." Tell the medical team exactly what happened, even if the head was never hit. If the problems continue after a normal CT, ask about seeing a neurologist and whether an MRI makes sense.
WHAT YOU CAN DO NOW
A few simple steps help both the medical care and any legal claim:
Tell your medical team about every symptom. Pay attention to what has changed — headaches, sleep, memory, mood, balance — and bring it up at every appointment, even if it seems small. A family member who has noticed changes should come along and say so. What the medical team hears is what ends up in the medical record, and the medical record is what counts.
Keep following up. Go to the appointments. Gaps in treatment are the first thing the other side points to.
Save the evidence. Photos of the place or thing that caused the injury, the shoes or equipment involved, medical records, the car if you still have it, ride tickets and wristbands, any video, any incident report.
Do not wait too long. In California, the deadline to bring an injury claim is generally two years, and it can be as short as six months when a government entity is involved.
HOW WE HELP
In our experience, the other side typically puts profits ahead of safety — and when someone gets hurt, it counts on the injury being invisible. It points to the missing bruise, the normal scan, the word "mild." Proving what really happened takes the right specialists, the right testing, experts who can show how the head actually moved, and the voices of the people who knew your loved one before and after. The law does not require an injury anyone can see. It asks what happened to the person.
This is the work Tobin Lanzetta has done for more than 20 years. He has spent those years litigating brain injury cases, including more than a decade on cases involving a roller coaster's restraint system. He has been recognized as a Best Lawyers in America "Best Lawyer — Product Liability Litigation" every year from 2020 through 2026, named to Super Lawyers every year since 2014 including the Super Lawyers Top 100 in Southern California, and has recovered over $200 million in total case results.
Lanzetta Law is a national trial firm with offices in Los Angeles and Santa Fe. If someone in your family has not been the same since a fall, a crash, or a ride, call us. The consultation is free, and we will listen.
Disclaimer: The information on this page is for general informational purposes only and is not intended as legal or medical advice. Nothing on this website creates an attorney-client relationship between you and Lanzetta Law. Every case is unique, and past results do not guarantee future outcomes. If you have questions about your specific situation, please contact an attorney for a personalized consultation.