The Use of SPECT in Personal Injury Cases

The Emerging Role of SPECT Scans in Personal Injury Lawsuits

A SPECT, single-photon emission computed tomography, is a type of brain diagnostic technology that creates a detailed 3D map of the blood flow activity in the brain to spot areas of impaired brain function. 

SPECT scans have been considered important in detecting evidence of traumatic brain injury, specifically where the injury is mild and undetectable on MRI or CT scans¹. Although SPECT scans provide valuable data, it cannot establish the source of the impairment. Because of this, the Superior Court of Justice has consistently upheld the position that SPECT scans can identify specific areas of dysfunction that are consistent with a brain injury, but an assessor cannot rely solely on SPECT scans to diagnose a mild traumatic brain injury (mTBI). Typically, a patient will need to present other evidence in support of their ongoing symptoms and functional impairments to support a diagnosis of mTBI. 

SPECT Scan In A Recent Ontario Licence Appeal Tribunal (LAT) Decision

In a recent case (Panchoo v. Aviva, 2023) released by the Licence Appeal Tribunal (LAT), a SPECT scan was used in supporting the diagnosis of an mTBI, resulting in access to benefits that were previously denied by the accident victim’s insurance company.

In this case, the victim was involved in a motor vehicle accident (MVA) where they did not strike their head directly causing a physical trauma, but rather experienced a violent thrashing from the impact, resulting in their brain injury. This type of injury is considered a closed brain injury where there is no penetrating injury to the brain with no break to the skull. The brain injury is a result of rapid movement that shakes the brain inside the skull, bruising and tearing brain tissue and blood vessels. 

Traumatic brain injuries can have a wide range of physical and psychological effects including, but not limited to, headaches, nausea, fatigue, dizziness, sensitivity to light, blurred vision, memory problems, mood changes, and problems with speech. Some symptoms manifest right away; however, others can take weeks or months to appear making diagnosis tricky.  

In this particular case, following the accident, the victim was seeking payment from their accident benefits insurer for a series of treatment plans to help with their recovery. These plans included psychological counselling, cognitive rehabilitation, and funding for an incurred neuropsychological assessment. Unfortunately, their car insurance provider deemed these benefits not reasonably necessary, thus denying the accident victim access to these benefits, even though they continued to suffer from cognitive, psychological, and physical struggles. Sadly, this is a reality we see with insurance providers happening all too often. 

Though an earlier assessment by the insurance company’s expert stated the victim’s mTBI symptoms would resolve within a year, the victim argued that the earlier assessments only represented a “snapshot in time” and that their condition had continued to evolve and change. Neurocognitive testing performed on the victim confirmed a major cognitive disorder. The SPECT scan the victim underwent identified blood flow abnormalities in their brain that were consistent with a TBI. 

With the help of a personal injury legal team and being equipped with the results of a neuropsychological assessment and the recent SPECT scan, the injured victim was able to successfully argue that their mTBI diagnosis was supported by objective evidence and that the treatment plans were necessary. They were ultimately awarded the funding they needed for their psychological and cognitive treatment from the insurance company. This case and the Vice Chairs endorsement of SPECT scans as objective evidence in support of an mTBI is a game changer. It suggests that a SPECT scan can be used successfully in a personal injury case and is recognized as acceptable evidence for the diagnosis of a mild traumatic brain injury. Hopefully, as these SPECT cases continue to resolve in the injured person’s favour, insurance companies will accept the legitimacy of the data and adjust mTBI claims accordingly, avoiding the need for a hearing altogether. 

For those impacted by a Traumatic Brain Injury (TBI), or their healthcare providers, our team has compiled additional resources that may be helpful. You can access our Traumatic Brain Injury Guide by clicking here, or read more about TBI in children in this article.