Closed Head Injury | Traumatic Brain Injury Lawyer | TBI Closed Head Attorney
Closed Head Traumatic Brain Injury
A closed head injury is a type of traumatic brain injury (TBI) where the hard bones of the skull do not break. This is in contrast to an open head injury (also known as a penetrating injury or perforating injury), which is caused when objects such as bullets, knives, nails, drill bits, hammers, high-velocity debris from explosions, or bone fragments from the skull are driven into or pass through the skull and damage brain tissue.
A closed head injury can result when the head hits an object, is violently shaken (shaken baby syndrome), or when there is no impact to the head at all but the brain moves rapidly forward and backward inside the skull (whiplash, coup-contrecoup injury). In a closed head injury, the object does not have to penetrate the skull or cause a skull fracture to damage the brain tissue.
Types of Closed Head Injuries
• Concussion - A person who suffers a concussion has a head injury with no structural or physical damage to the brain. He or she may not even lose consciousness. Headache, amnesia (loss of memory), and confusion can be subtle and might not appear right away. When they do come, concussion symptoms can last for days, weeks, or even longer. The amnesia almost always causes the person not to remember the blow that caused the concussion.
When a young person receives a second concussion before healing from an earlier concussion, he may be at risk for developing a very rare but deadly condition called “second-impact syndrome.” In second impact syndrome, the brain swells catastrophically after even a mild blow, sometimes causing disability or death.
• Contusion - A contusion is a bruise. A cerebral contusion is a TBI caused by a blow to the head. Contusions happen often in coup contre-coup injuries. In a coup injury, the brain directly under the area of impact is injured. In a contre-coup injury, the area on the opposite side of the impact is injured.
Mild contusions may get better by themselves. In other cases, the bruising may cause swelling and microhemorrhages, or small blood vessel leaks. Microhemorrhages (multiple petechial hemorrhages or multifocal hemorrhagic contusion) may increase intracranial pressure inside the skull that may crush and damage delicate brain tissue. Swelling is usually worst around four to six days after the injury and may require surgery to relieve the pressure. Contusions can cause numbness, weakness, loss of motor coordination, inability to speak, and problems with memory and thinking. The prognosis for recovering from a contusion that causes coma is poor for victims who experience a shearing (twisting) injury to the brain.
• Hematoma - A hematoma is a pooling of blood caused by torn and bleeding veins from a blow to the head. A subdural hematoma is blood that collects in the space between the outer layer and the middle layers of the brain's covering. Symptoms of hematoma are headache, drowsiness, confusion, weakness or paralysis on one side, enlarged or different sized pupils, coma, convulsions, and loss of consciousness after a head injury. Small hematomas without symptoms may not need to be treated, while other, more serious hematomas require surgery. Recovery is usually complete with rapid treatment, although headache, inability to sleep, attention problems, and anxiety may continue for a period of time.
• Diffuse Axonal Injury - Diffuse axonal injury (DAI) is a devastating traumatic brain injury. In DAI, the axon, or the part of the nerve that helps carry information to the brain, does not function properly. DAI results from the traumatic shearing (twisting) of the brain where tissue becomes damaged as it slides over other tissue when the head rapidly speeds up (accelerates) or slows down (decelerates). The damage happens over a widespread area of the brain and is one of the major causes of coma and persistent vegetative state after head trauma. DAI occurs in about half of all cases of severe head trauma, and may occur in moderate and mild brain injury. Ninety (90) percent of victims with severe DAI never regain consciousness, and if they do, they are likely to be significantly impaired and disabled.
• Post-Concussion Syndrome - Post-concussion syndrome (PCS) is also known commonly as "shell shock" or post-concussive syndrome. Symptoms include headache, difficulty concentrating, and irritability after a concussion, or a moderate or severe traumatic brain injury. PCS may occur in thirty-eight (38) to eighty (80) percent of mild traumatic head injuries. The treatment for PCS is to treat the symptoms with medication and physical and behavioral therapy. The symptoms disappear after a period of time in the majority of cases.
• Secondary Injury - Secondary injury can cause brain damage and death in the hours, days, and weeks following the primary traumatic brain injury. Instead of improving in the hospital, about forty (40) percent of people with traumatic brain injury deteriorate when a secondary injury damages parts of the brain that were unharmed in the primary injury. Secondary injury includes edema (swelling of the brain), ischemia (insufficient blood flow), hypotension (low blood pressure), cerebral hypoxia (insufficient oxygen in the brain), and raised intracranial pressure (the pressure within the skull). Another form of secondary injury involves damage to brain cells through complex chemical reactions in the brain called a biochemical cascade.
Anoxic Brain Injury
The brain needs oxygen. Total lack of oxygen is called anoxia. If oxygen levels are low for four minutes or longer, brain cells begin to die. After five minutes permanent anoxic brain injury, also called cerebral hypoxia or hypoxic-anoxic injury (HAI), can occur.
Anoxic brain injury can be mild, moderate, or severe. The longer the brain is deprived of oxygen, the more widespread and serious the injury. Severe anoxic brain injury is life-threatening and can result in coma or persistent vegetative state. Moderate anoxic brain injury yields a better outcome, but recovery may take months or years of rehabilitation. Those with mild anoxic brain injury usually make a full or nearly full recovery, and are able to live lives that are relatively normal and symptom-free.
Talk to a Denver brain Injury lawyer today if you believe you or someone you love has suffered anoxic brain injury, which can be a result of a traumatic injury to the brain from a car accident, truck accident, motorcycle accident, shaken baby syndrome, whiplash, exposure to blasts, explosions, dangerous drugs, medical malpractice, slip & falls, construction accidents, work accidents, trip & falls, or lack of oxygen during surgeries, drowning events, complications at birth, or toxic or hazardous chemicals like lead, mercury, or manganese.
Chronic Pain Syndrome and Brain Atrophy Attorney
Recent studies suggest that people who do not have a direct injury to the brain in the beginning, but instead, have been given a diagnosis of chronic pain or chronic pain syndrome for at least six (6) months from an illness, a serious car accident, or some other serious accident, may develop shrinking (atrophy) of the brain's gray matter of up to eleven (11) percent that can be shown on an MRA (Magnetic Resonance Angiography) or MRI (Magnetic Resonance Imaging). An eleven (11) percent reduction in the size of the brain is roughly equivalent to the loss of gray matter that occurs in ten to twenty years of aging. It is estimated that a person loses 1.3 cm3 of gray matter for every year of chronic pain. The longer the pain lasts, the greater the loss of brain volume.
Later studies have found that the loss of gray matter is partly reversible when pain is treated successfully. Though it is not abundantly clear, some researchers believe that the brain shrinkage is not brain damage, but instead is the result of long term changes in the chemicals of the brain. When the pain stops with treatment, the brain chemicals get back to normal, and the brain may return to normal size.
Atrophy from chronic pain is a new area of brain science, and a Denver personal injury lawyer will have knowledge and information for clients who have experienced chronic pain for more than six (6) months. For example, in years past, the science was not there to assist a Denver personal injury attorney in proving that a work-related back injury could lead to brain damage; today, however, the science is there to support such a claim, but without a knowledgeable Denver brain injury attorney, proving it would be next to impossible.
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Denver Shaken Baby Syndrome Law Firm
Deadly brain damage can occur when a baby is violently shaken, causing the head to move rapidly and forcefully forward and backward. This type of traumatic brain injury is often referred to as "shaken baby syndrome." For many years, prosecutors and medical professionals have looked for the “triad” of physical brain injury symptoms – subdural hemorrhaging (bleeding in a space between the skull and the brain), retinal hemorrhaging (bleeding at the back of the eyes), and swelling of the brain — to diagnose a baby’s brain injury as “shaken baby syndrome.”
More recently, there has been strong disagreement among doctors and other experts about the shaken baby diagnosis. A small but growing number of doctors warn that there can be alternate explanations for the symptoms associated with shaken baby syndrome, such as infections, bleeding and clotting disorders, and infant stroke. Contact a Denver brain injury lawyer if you believe a child has been injured or killed as a result of being shaken.
Fatalities & Death Rate From Traumatic Brain Injury
Whether a victim of TBI will die depends heavily on what caused the head injury. In the United States, eighty-nine (89) percent of patients with fall-related TBIs survive, while only nine (9) percent of patients with penetrating open head injuries, projectile, or firearm-related TBIs survive. Blasts or explosions often cause closed head injuries and traumatic brain damage from dramatic changes in atmospheric pressure; objects thrown into the air by the blast hitting people; or people being thrown into motion by the blast. Unfortunately, United States military troops in Iraq have suffered so many blasts and explosions that traumatic brain injury has been coined the “signature injury” of Operation Iraqi Freedom.
Penetrating injuries and firearms are the most common cause of fatal TBI, followed by car, truck, and motorcycle accidents, and then slip and falls and trip and falls. If you or someone you know has suffered a traumatic brain injury, call a Denver brain injury lawyer today.
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