Understanding the Nature of These Accidental Tragedies

1. VEHICULAR TRAUMATIC
BRAIN INJURIES
Understanding the Nature of These Accidental Tragedies
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2. HOW TBIS HAPPEN
Traumatic brain injuries, or TBIs, can have many causes: accidents,
falls, sports, and violent assaults. A little more than 50,000 people
die each year in the U.S. from all causes of TBI.
It is the leading cause of death and disability of those under 45. Over
1.5 percent of all U.S. residents—5.3 million people—are living with
disabilities that resulted from a TBI. That’s about one in every 66
people.
A large number of TBIs arise from motor vehicle accidents, the
second or third most common cause of brain injury, depending on
the source of the statistics.
Among those aged 5 to 24 (the data is from years 2006-2010), TBIs
from auto accidents were the leading cause of death. When it
came to hospitalizations for the same time span, TBIs were the
leading reason for admission for those aged 15 to 44.
The percentages of those injured or killed by vehicular-related TBIs
vary; some peg the number as high as 51 percent. One thing that is
certain is that TBI is hardly rare, and the emotional and financial
costs can be extreme.
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3. TYPES OF TBI (OPEN VS.
CLOSED-HEAD)
TBIs can entail no external wounds (meaning closed-head trauma)
or include external damage (meaning open-head trauma).
Open-head or penetrating brain injuries often involve invasive,
external objects such as bullets or knives, though open-head injuries
can also result from skull fractures. Such TBIs are called focal injuries
because they affect a very specific, or focused, area of the brain.
In contrast, closed-head TBIs are diffuse, meaning the injury often
occurs throughout the brain. In a closed-head TBI, the brain impacts
the inside of the skull, either damaging the entire brain or one or
more specific areas. The hallmarks of closed-head TBIs are injuries
arising from external forces that shake or shear the brain or result in
an external head impact.
When the forces are great enough, the cushioning fluid that
surrounds the brain is not sufficient to prevent damage. Motor
vehicle accident TBIs tend to be closed-head.
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4. TBI CLASSIFICATIONS –
MILD TO SEVERE
Traumatic brain injuries can range from mild to severe, depending on the
score registered on the Glasgow Coma Scale (GCS). The GCS grades a person’s
level of consciousness from 3 to 15, with 15 being the least severe. TBIs can
also be classified according to the following symptoms:
 Mild TBIs, 13 to 15 on the GCS, are characterized by a brief loss of
consciousness (up to a few minutes), post-traumatic amnesia (PTA) of less
than one hour, and normal brain imaging results. Note that “mild” does not
necessarily mean that the brain injury is of no consequence. All brain
injuries are significant.
 Moderate TBIs are characterized by a loss of consciousness lasting from 1
to 24 hours, PTA of 1 to 24 hours, and abnormal brain imaging results. An 8
to 12 on the coma scale is another hallmark, along with confusion and
other cognitive impairment that can last for weeks. Sometimes the person
suffers permanent brain damage.
 Severe TBIs involve a GCS of less than 8, a loss of consciousness or coma
for more than 24 hours, amnesia for more than 24 hours, and abnormal
brain scans. Comas, various vegetative states, and Locked-In Syndrome
(being aware but unable to move or speak) can all signify severe TBI.
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THE KINDS OF TBIS MOST
COMMON TO CAR ACCIDENTS
While many kinds of brain injuries exist, certain types
are most likely in car accidents. The forces involved in
collisions often create closed-head injuries that can
show few external signs of injury, though the internal
damage may be quite serious. In the next few pages,
we will look at some of the most common forms of TBI
in vehicle accidents…

6. CONCUSSION
Often classified as the mildest form of TBI, concussions can
be caused when the head impacts something, such as the
steering wheel or the side frame of the car’s interior.
Concussions can also be caused by acceleration or
deceleration injuries where the brain moves suddenly
inside the skull in response to external forces generated by
the accident’s impact. One form of this is called whiplash.
If you are in a stationary car that is hit, you can suffer
acceleration damage. If you are moving and hit something
stationary, you can suffer deceleration damage.
Concussions injure the entire brain, and healing can take
up to several weeks.
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7. DIFFUSE AXONAL INJURY
When the brain’s motion inside the skull trails the skull’s
movement, it can cause shearing forces that tear nerve
tissue inside the brain.
These strong forces stretch the nerve tissues, or axons,
until they tear.
Diffuse axonal injury is often widespread and permanent.
Such an injury can be severe, and may even cause death.
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8. CONTUSION
When the head hits another object, contusion can occur.
A contusion means that a specific area of the brain is
bruised, and the bruise can be a coup or a contrecoup
injury.
A coup contusion happens on the side of the brain that
sustains the impact, while a contrecoup contusion occurs
on the opposite side, a result of the brain’s striking the
skull on the inside.
The risk of bleeding in the brain is always present with a
contusion, though it does not always occur.
Should bleeding result in a clot, or hematoma, surgery
may be needed to remove it.
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9. THE AFTERMATH OF A TBI
After an accident, a TBI can give rise to changes in
consciousness, mental states, and memory. Certain areas
of the brain can be short-circuited, notably those
responsible for thinking and reasoning, the five senses,
communication and understanding, and emotions
(depression, anxiety, aggression, and inappropriate
behaviors).
These changes can be short-term or long-term, and can
cause problems not only for the injured person but also for
their family and friends.
A TBI can also trigger epilepsy or increase the risk of brain
disorders that become more likely as we age, such as
Alzheimer’s or Parkinson’s diseases.
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10. REPEATED TBIS & SECOND-
IMPACT SYNDROME
Repeated TBIs, even mild ones, over the years can
bring about significant cognitive problems, such as
those that have occurred with professional boxers and
football players. Repeated TBIs, which happen only
hours or days apart, can result in Second-Impact
Syndrome. Rapid death often follows.
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11. HEALING FROM A TBI
If you have been in an accident in which you sustained a
TBI, even a mild one, it is critical that you rest and avoid
activities that could expose you to the risk of a second
brain injury in a short period of time.
Recovering from a TBI can take much longer than you
might think, so it is important to follow the instructions
your health professional gives you regarding when it is safe
to drive, ride a bike, and use heavy or dangerous
equipment.
Be sure to seek professional help should you need to
relearn life skills.
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12. www.indianapilaw.com
HAVE YOU SUSTAINED A
TRAUMATIC BRAIN INJURY?
If you or a loved one has suffered a TBI due to the negligence of another person,
the Indiana traumatic brain injury attorneys at Stephenson Rife can help. Mike
Stephenson, a personal injury lawyer with Stephenson Rife of Shelbyville, Indiana,
near Indianapolis, has been successfully litigating these types of cases in Indiana
since 1982.
Call him at 317-680-2011 or visit the website to learn more about what
Stephenson Rife can do for you.