Frontotemporal Brain Damage: Personality Changes After a Bergen County Accident

The hardest brain injuries to prove are the ones that change who someone is.

When a car accident damages the frontal and temporal lobes, the symptoms often aren’t physical in any obvious way. There’s no paralysis or visible wound. Instead, the person starts behaving differently. Perhaps they lose their temper over nothing, make impulsive decisions they never would have made before, say inappropriate things in social situations, or become apathetic and emotionally flat. 

These changes are the result of physical damage to the parts of the brain that regulate personality, judgment, and emotional control. During a collision, the brain slams against the inside of the skull, and the frontal and temporal lobes take the worst of it because of where they sit and how the skull is shaped. The damage happens at a microscopic level.

The problem is that standard imaging often misses it. A CT scan or MRI from the emergency room might come back clean because those tests are designed to detect bleeding and fractures, not microscopic white matter damage. The insurance company will point to that “normal” scan and argue the injury doesn’t exist, or that the personality changes are unrelated to the accident.

At Maggiano, DiGirolamo & Lizzi, P.C., our attorneys have the experience to handle these sensitive cases. If you or a loved one is experiencing personality changes after an accident, call us today to learn how we might be able to help.

Key Takeaways for Frontotemporal Brain Damage Claims

1. Personality and mood changes are physical injuries. Drastic shifts in behavior, such as increased anger, apathy, or poor judgment, are frequently symptoms of damage to the brain’s frontal and temporal lobes and can be included as part of a personal injury claim.
2. Standard medical imaging may not show the full injury. While CT scans and MRIs can rule out skull fractures or bleeding, they commonly miss microscopic damage to the brain’s white matter. Advanced techniques, such as Diffusion Tensor Imaging (DTI), are often necessary to provide objective evidence of the trauma.
3. New Jersey’s laws have specific rules for brain injury cases. The state’s discovery rule might extend the time you have to file a claim if symptoms develop late, and overcoming the verbal threshold to sue for pain and suffering hinges on proving a permanent injury with objective medical evidence.

Why Car Accidents Are a Common Cause of Frontotemporal Damage

During a crash, the head can whip forward and backward violently, causing the brain to slam against the inside of the skull. This is known as a coup-contrecoup injury. The brain, a soft organ floating in cerebrospinal fluid, first hits the skull at the point of impact (the coup) and then recoils, hitting the opposite side of the skull (the contrecoup).

The frontal and temporal lobes are especially vulnerable in these situations. The frontal lobe sits directly behind the forehead, and the temporal lobes are on the sides, near the temples. The bony ridges inside the skull in these areas are uneven, and the impact can cause bruising, tearing of nerve fibers, and shearing of blood vessels. This microscopic damage disrupts the intricate neural networks that control our personality, decision-making, and emotional regulation.

Following the initial trauma, the brain begins a healing process. Part of this process is gliosis, where glial cells rush to the site of injury to form a scar. While this is a protective mechanism, the resulting scar tissue can permanently interfere with the electrical signals in the brain, leading to long-term or permanent changes in function and behavior.

Why Standard Scans Often Miss the Damage

A person might be discharged from the emergency room with a “normal” CT scan or MRI, yet their family notices unsettling changes in their personality in the weeks and months that follow. As mentioned, this is because conventional imaging is excellent at detecting macroscopic injuries like skull fractures, tumors, or significant bleeding, but it cannot visualize the brain at a microscopic level.

Diffusion Tensor Imaging (DTI)

The real damage from a coup-contrecoup injury is commonly to the white matter tracts—the brain’s communication highways. Advanced imaging techniques, like Diffusion Tensor Imaging (DTI), are needed to see this kind of injury. 

DTI measures the flow of water molecules through the brain’s white matter, allowing neurologists to identify areas where the normal flow is disrupted. This provides objective, physical evidence of the injury that can be presented in a legal claim.

Without this evidence, insurance adjusters may try to dismiss personality changes as purely psychological or unrelated to the accident. We recommend seeking a referral to a neurologist who specializes in TBI and has access to advanced imaging technology if you suspect this type of injury.

Legal Hurdles in New Jersey Brain Injury Claims

Securing fair compensation for frontotemporal brain damage involves clearing several legal hurdles specific to New Jersey law. These cases are complicated not only by the medical proof required but also by the procedural rules that govern personal injury lawsuits.

Anosognosia: When the Injured Person Doesn’t Recognize the Injury

A particularly tricky aspect of frontal lobe damage is a condition called anosognosia, a lack of self-awareness about one’s own deficits. The majority of individuals with moderate-to-severe TBI are affected by this condition. Someone with anosognosia might insist they are fine, refuse medical treatment, or become agitated when family members point out their changed behavior. This can make seeking legal and medical help very difficult.

In these situations, the testimony of family, friends, and coworkers becomes indispensable. Documenting specific instances of changed behavior provides crucial evidence for the claim. 

The Statute of Limitations and the Discovery Rule

In New Jersey, you generally have two years from the date of an accident to file a personal injury lawsuit. This deadline is known as the statute of limitations. 

However, brain injury symptoms, especially personality changes, might not become fully apparent for months. A person might seem fine at first, only for their family to notice a gradual but steady decline in their executive function or emotional control.

This is where New Jersey’s discovery rule may come into play. The discovery rule can pause the two-year clock until the point where the injured person knew, or reasonably should have known, that they had sustained an injury. Arguing for the application of the discovery rule requires a detailed timeline of symptoms and medical consultations to show that the nature of the injury was not immediately apparent after the accident.

The AICRA Verbal Threshold

Many New Jersey auto insurance policies include a Limitation on Lawsuit option, also called the verbal threshold or tort threshold. Under the Automobile Insurance Cost Reduction Act (AICRA), if you have this type of policy, you cannot sue for non-economic damages, such as pain and suffering, unless your injury falls into one of several categories. For frontotemporal brain damage, the most relevant category is permanent injury.

To meet this requirement, the law states that a body part or organ “has not healed to function normally and will not heal to function normally with further medical treatment.” This must be certified by a physician and supported by “objective, credible medical evidence.” A neurologist’s report interpreting a positive DTI scan is strong, objective evidence that can help satisfy this standard and allow you to seek compensation for the full impact of the injury on your life.

Types of Compensation Available in a TBI Claim

A successful claim can provide financial stability and resources for the long road ahead. Compensation is typically broken down into several categories:

• Economic Damages: This includes all the tangible financial losses resulting from the injury, such as past and future medical bills, lost wages, diminished earning capacity, and costs for rehabilitation or in-home care.
• Non-Economic Damages: This compensation is for the intangible, human losses. In a brain injury case, this is especially significant. It includes pain and suffering, emotional distress, and hedonic damages, which relate to the loss of enjoyment of life. While New Jersey does not recognize hedonic damages as a separate claim, the loss of one’s ability to enjoy hobbies, relationships, and daily activities is considered part of the overall damages for a permanent injury.
• Loss of Consortium: The spouse of an injured person may file a claim for loss of consortium. This addresses the loss of companionship, affection, support, and services that the injury has caused within the marital relationship.

It is also important to understand New Jersey’s rule on comparative negligence. If you are found to be partially at fault for the accident, your compensation award will be reduced by your percentage of fault. As long as your fault is not greater than that of the other party, you may still recover damages.

The Eggshell Plaintiff Doctrine: Taking the Victim as They Are

In some cases, an accident victim may have a pre-existing condition that makes them more susceptible to a brain injury. An insurance company might argue that a minor impact should not have caused such severe damage and try to deny the claim. However, New Jersey law follows the eggshell plaintiff doctrine.

This legal principle holds that a defendant is responsible for all the harm that results from their negligence, even if the victim was unusually vulnerable. The at-fault party does not get a discount because the person they hit was more fragile than the average person. We must take the victim as we find them. If the defendant’s wrongful act aggravated a pre-existing condition or caused an injury that would not have happened to someone else, they are still liable for the full extent of the damages.

How a Bergen County Brain Injury Attorney Can Help

An experienced attorney will manage the entire legal process, including:

• Investigating the Accident: We will gather all evidence related to the crash, such as police reports, witness statements, and traffic camera footage, to establish the other driver’s breach of their duty of care.
• Working with Medical Experts: We collaborate with neurologists, neuropsychologists, life care planners, and vocational experts to build a comprehensive picture of the injury and its long-term consequences. These experts provide testimony and reports that explain the medical science in clear terms and quantify the future costs associated with the injury.
• Documenting the Before and After: We interview family, friends, and colleagues to gather stories and specific examples that illustrate the changes in you or your loved one’s personality and daily functioning. 
• Negotiating with Insurance Companies: We handle all communications with the insurance adjusters. We know the tactics they use to downplay these injuries and are prepared to counter their arguments with solid evidence and legal precedent.
• Litigating the Case: If a fair settlement cannot be reached, we are fully prepared to take your case to trial. We will present a thoroughly documented case to a jury to fight for the compensation you and your family deserve.

You should not have to pay out of pocket for these expenses or chase down who is responsible while you or your loved one are still recovering. Let a dedicated legal team manage the fight for fair compensation.

Frequently Asked Questions

How long will a brain injury lawsuit take?

These cases are difficult and rarely resolve quickly. The timeline depends on many factors, such as the severity of the injury, the time it takes to reach maximum medical improvement, and whether the insurance company is willing to negotiate a fair settlement. A case could take anywhere from one to several years to resolve, especially if it proceeds to trial.

Can I still file a claim if the accident was partially my fault?

Yes. New Jersey follows a modified comparative negligence rule. You can recover damages as long as you are not found to be more than 50% responsible for the accident. Your total compensation will be reduced by your percentage of fault.

Can personality changes from frontal lobe damage be treated?

Some symptoms can be managed, but the damage itself is often permanent. Cognitive rehabilitation therapy can help patients develop compensatory strategies for executive function deficits. Medication may address specific symptoms like irritability, depression, or impulsivity. However, treatment doesn’t restore the damaged neural pathways—it helps the person adapt to their new limitations. The cost of ongoing therapy, medication, and support services becomes part of the damages claim, potentially for the rest of the person’s life.

What if the person can still work but their marriage is falling apart?

Employment isn’t the only measure of damage. Frontal lobe injuries frequently devastate relationships even when the person can technically perform job tasks. A spouse may file a loss of consortium claim for the loss of companionship, emotional support, and the marital relationship they had before the injury.

Don’t Let Anyone Undervalue Your TBI Claim

Insurance companies know these cases are difficult to prove. But with the right help, it’s possible to secure fair compensation for every cost associated with frontotemporal brain damage.

If someone in your family has changed after a Bergen County accident, call us today for a free consultation. We’ll tell you whether the evidence supports a claim and what it will take to prove it.