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The risks of traumatic brain injury have been attracting a great deal of well-deserved attention in recent years. Will Smith’s new movie, “Concussion,” draws much-needed attention to the types of brain injuries suffered by professional football players, as has the class action lawsuit brought against the National Football League by former players seeking damages for injuries resulting from repeated head trauma. As many as one in five returning veterans suffer from a traumatic brain injury as well. Traumatic brain injury, however, is not limited to the football field or the field of battle. It is one of the most common injuries suffered by motor vehicle accident and fall victims.
Understanding The Basics of Traumatic Brain Injury
What exactly is a traumatic brain injury, or, TBI? Traumatic brain injury arises from two causes -- either open or closed head injuries. Open head injuries, also called penetrating injuries, occur when an object penetrates the brain. The effects of an open head injury are typically specific to the area of the brain involved. Closed head injuries, on the other hand, are caused by direct blows to the head (such as when the head strikes an interior surface in a car crash, or a hard surface as a result of a fall). A closed head injury may also occur after sudden acceleration or deceleration accompanying an impact, causing the brain to move quickly back and forth within the skull cavity.
In addition, there are two types of traumatic brain injury – primary brain damage and secondary brain damage. Primary brain damage is the damage caused immediately at the time of the impact. Secondary brain damage arises after the injury, typically from swelling or increased blood pressure in the skull. Persistent swelling, after even one injury to the brain, can result in serious brain degeneration. Secondary brain damage can also be caused by other factors such as oxygen deprivation, also referred to as “hypoxia”.
Often in motor vehicle accidents (MVAs), sudden acceleration and deceleration can cause what is known as a “coup-contrecoup” injury, where the brain essentially “bounces” off one side of the interior of the skull and strikes the other. This can cause localized lesions or bleeding that may be detectible through the use of standard imaging studies such as an MRI. In some cases, imaging may not detect the damage.
The most common damage associated with acceleration/deceleration injuries in motor vehicle crashes is diffuse axonal injury(DAI). DAI occurs when the brain deforms in response to sudden acceleration or deceleration. The white matter of the brain then tears in a non-localized, or “diffuse” manner, commonly affecting portions of the brain associated with cognition as well as social and behavioral control.
Causes, Complexities and Challenges of TBI
According to the Centers for Disease Control, falls and motor vehicle crashes are the leading causes of traumatic brain injury. These incidents account for more than half of traumatic brain injuries resulting in emergency room care, hospitalization, or death in the United State. (http://www.cdc.gov/traumaticbraininjury/get_the_facts.html). The CDC also reports:
The damage from a traumatic brain injury can range from mild to severe and the effects can vary widely from person to person. Some victims may make a full recovery within a few weeks or months while others suffer lifelong mental or physical disabilities. Because TBIs can be difficult to detect, clinicians may miss subtle but serious bruising or bleeding in the brain. With millions of Americans affected by TBI each year, attorneys who handle personal injury cases must have a thorough understanding of traumatic brain injury, its mechanisms, and the devastating effects it can have on its victims.
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