Types of Brain Injuries
Representing Injured Victims in All of Hawaii
Brain injuries can affect one area of the brain, multiple areas of the brain or the brain
as a whole, depending on which parts of the brain sustained the most damage.
No two accidents or injuries are exactly the same, and the type and extent
of damage from a brain injury can vary dramatically. The two primary types
of brain injuries are traumatic brain injuries and acquired brain injuries.
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Traumatic Brain Injuries
When external force is applied to the skull by either a violent jolt or
blow to the head, it can result in traumatic injury to the brain. As reported
by the CDC, there were more than two and a half million Traumatic Brain
Injuries (TBIs) in the United States in a recent year. While many of the
TBIs occurred as a result of a direct injury to the head, sustaining a
TBI in conjunction with another type of injury is not uncommon. If you
or a loved one has sustained a traumatic brain injury, it will fall into
one of the following categories.
Any injury to the head or brain is traumatic and can be capable of causing
substantial damage. Individuals who have sustained concussions often require
only observation and may require little treatment and not need extensive
rehabilitation or surgery. There are cases that may necessitate additional
or long-term treatment programs, depending on the extent of the injury
A concussion is the most common type of TBI and can be caused by a whiplash
type injury from:
- An auto accident
- A blow to the head
- A gunshot wound
- Violent shaking of the head
- An open or closed head injury
Not all people with TBI will experience a loss of consciousness. Some may
simply feel dazed and confused. Concussions do not always show on a CAT
scan or other type of diagnostic imaging test. This type of injury can
result in intracranial swelling, blood on the brain or blood clots. Most
concussions cause only temporary damage and recovery can be achieved in
as little as a few months.
A contusion is a rupturing of blood vessels resulting in bleeding on the
brain. Contusions are primarily caused by a direct impact to the head.
In severe cases, a cerebral contusion may have to be surgically removed
to prevent further damage from being caused.
Coup - Contrecoup
Coup-contrecoup is a term used to describe a traumatic brain injury resulting
in a cerebral contusion both at the point of impact and on the opposite
side of the brain. This type of TBI occurs when the impact of the blow
is forceful enough to cause the brain to bounce back and forth inside
A diffuse axonal injury is one of the more common types of traumatic brain
injuries. It is also one of the most severe. If left untreated, a diffuse
axonal closed head injury may result in death. One of the most common
signs of a diffuse axonal injury is unconsciousness. The term "diffuse"
describes the widespread damage that occurs from an axonal injury. In
a diffuse axonal injury there will be excessive tearing of the nerve tissue
in the brain. There also will be a temporary or permanent disruption of
nerve cells, thus inhibiting the brain's ability to communicate with
the rest of the body.
This type of injury can be seen in:
- Auto accidents
- Domestic violence
- Shaken Baby Syndrome
- Sports accidents
This type of TBI is self-explanatory in that it results from the penetrating
impact of a knife, bullet or other sharp object. In this type of injury,
the force of the impact can cause hair, skin, bone fragments and various
contaminates to be lodged in the brain. When bullets or other objects
bounce around within the skull, the damage to the brain can be extensive.
These types of TBI often result in permanent damage or death.
Acquired Brain Injuries: Anoxia & Hypoxia
Acquired Brain Injuries (ABI) differ from traumatic brain injuries in that
these types of injuries are typically caused by injuries caused after
birth, such as those stemming from a degenerative disease, substance abuse,
strokes, tumors, oxygen deprivation, toxins, near drowning or infection.
An ABI is not necessarily caused by a blow to the head.
Anoxia is a type of brain injury that occurs when the brain is completely
deprived of oxygen for a period of time. This type of brain injury can
be caused by a lack of oxygen, blood containing insufficient oxygen or
toxins interfering with the body's ability to effectively use the
oxygen found in the blood.
Hypoxic brain injuries are also caused by oxygen deprivation. In this type
of acquired brain injury, oxygen is getting to the brain, but it is not
enough to allow the brain to function in its usual capacity. Hypoxic brain
injuries often occur when there is a dramatic drop in blood pressure or
the flow of blood to the brain has been hindered. What are the symptoms
associated with each of the different levels of brain injury?
There are three levels of brain injury:
- Mild traumatic brain injury
- Moderate traumatic brain injury
- Severe brain injury
The severity of an individual's brain injury can be measured by the
Glasgow Coma Scale (GCS), which is the standard scoring system used to
determine the neurologic state of a recent head trauma victim.
- A GCS score between 13-15 indicates a mild traumatic brain injury
- A GCS score between 9-12 indicates a moderate traumatic brain injury
- A GCS score below 9 usually indicates a severe brain injury
Possible Symptoms of Mild, Moderate, & Severe TBI
Individuals who sustain mild traumatic brain injuries will often experience
a brief loss of consciousness, or at the very least feel somewhat dazed
and confused. Tests and scans will usually appear normal. This may make
diagnosis impossible until or unless the individual exhibits signs of
altered brain functionality, as can be seen with concussions.
When an individual receives a violent blow to the head, or a vicious shaking,
it may result in a moderate TBI. In these instances, unconsciousness could
last anywhere from a few minutes to a couple of hours. Disorientation
and confusion can be prolonged for weeks. Depending on the severity of
impact, the victim of a moderate TBI may experience some level of physical,
cognitive or behavioral deterioration on either a temporary or permanent basis.
Severe brain injuries are the most life-altering type of brain injuries
commonly resulting in permanent, irreversible damage to the brain. This
type of injury can lead to neurological defects, degenerative brain disorders
and other long-term problems.
Symptoms may include:
- A long period of unconsciousness
- Loss of memory
Deficits or difficulties involving cognitive, speech, sensory, perceptual,
physical, social, emotional, and other functions are extremely common.
Most individuals who sustain severe brain injuries will never fully recover.
What Are the Signs of Secondary Brain Damage?
Following a traumatic head injury, it is important that victims watch out
for signs of secondary brain damage.
Some of the most common signs of secondary brain damage are:
- Swelling on the brain (edema)
- Intracranial pressure
- Inexplicable fever
- Changes in blood pressure
- Cardiac issues
- Lung difficulties
Physical & Cognitive Problems Experienced by Injured Victims
A traumatic brain injury (TBI) can lead to a number of serious and life-altering
problems. If you have sustained a TBI, these are some of the physical,
cognitive and communication problems you can expect to endure:
Physical problems can include:
- Loss of hearing
- Blurred vision
- Decreased sense of smell or taste
An individual's strength, coordination and ability to concentrate can
also be affected. Cognitive problems will often appear as an inability
to concentrate (particularly when there are external distractions), difficulty
processing new information, short-term memory loss, impulsive reactions
or trouble carrying through tasks to completion.
Communications problems that may develop include an inability to stay on
a particular topic of conversation, difficulty discerning sarcasm, trouble
responding to non-verbal communications (facial expressions or body language)
and problems keeping up in a conversation. Emotional outbursts are more
common after a TBI as well.
Treating Traumatic Brain Injuries
Receiving proper treatment after a TBI is essential to an individual's
recovery. Once emergency medical care has been completed, many doctors
will employ a combination of treatment methods including medication, rehabilitation
and in some cases, surgery.
Diuretics may be prescribed to help reduce pressure inside the brain. Anti-seizure
drugs can significantly reduce an individual's chances of having a
life-threatening seizure, particularly within the first few weeks following
your injury. In cases where the TBI was sufficiently severe to require
the patient be put into a coma, coma-inducing drugs may be administered.
Surgery can be beneficial in the removal of hematomas or cerebral contusions
that have been putting pressure on the brain. Surgery can also be used
to repair skull fractures or open a portion of the skull to release pressure
and drain excess fluid.
Rehabilitation is the lengthiest portion of a TBI patient's recovery
program. The level of severity will determine what types of rehabilitation
specialists a patient may be required to see, as well as how long treatment
will need to be continued.
Rehabilitation specialists can include:
- TBI nurse specialists
- Physical therapists
- Rehabilitation nurses
- Occupational therapists
- Speech and language pathologists
- Social workers
Following through with a doctor's recommended treatment plan will help
dramatically reduce of the risk of secondary or further damage being caused
to the brain.
Honolulu Personal Injury Lawyers: Offering Trusted Legal Representation
Surviving a traumatic brain injury, or taking care of an individual who
has sustained a traumatic brain injury, can be very difficult. Rest assured
you are not alone. There are countless resources and support programs
that you can access to help you along the way. Our firm is also here to
provide you with trusted legal representation, particularly in cases where
a TBI has been caused as a result of another person's negligence or
neglect. Leavitt Yamane & Soldner is Hawaii's trusted injury law firm.
now to find out what we can do for you.