Brain Trauma and Head Injuries

brainpicAs a Sacramento Brain Injury Attorney I have represented a great many clients over the years who have suffered horrible head trauma and brain trauma as a result of an auto accident or motorcycle accident.

An important aspect of the job is having at least a basic understanding of the different types of Traumatic Brain Injury, as well as the variances in Brain Trauma caused by Motor Vehicles Accidents and Motorcycle Accidents.

Brain Trauma and Head Injuries

TYPES OF CRANIAL TRAUMA
Cranial trauma ordinarily does not raise difficulty in diagnosis. It is the most obvious of all diseases because the causative event is so definite. The pathological process is brief, the major part lasting seconds or at most minutes.

IMMEDIATE MEDICAL PROBLEMS
The immediate medical problem consists essentially of preserving life and counteracting the complications of impaired cerebral function.

MAJOR TRAUMA TYPES – Cranial trauma can be divided into three major types, according to mechanism :

1) Penetrating injuries.
2) Blunt acceleration deceleration injuries.
3) Compressive-distortive injuries.

PENETRATING INJURIES
Penetrating injuries happen relatively infrequently in civilian life. They involve high velocity missiles that strike the cranium with such force as to break the skull and tear asunder the meninges and brain. Immediate and fatal hemorrhage is the usual result, though lesser degrees of bleeding are compatible with survival.

BLUNT MOTION INJURIES
Blunt Acceleration-Deceleration Injuries, the common type in civilian life, have been the most thoroughly studied; and most of the published descriptions are devoted to
this subject. The milder degrees of acceleration of the stationary head by a blunt striking force, or deceleration of the rapidly moving head by an immovable surface, frequently cause only concussion.  An experienced Sacramento Head Injury Attorney should be familiar with, and have a general understanding of the types of damage that can be caused by such trauma.

“ABOLITION OF CONSCIOUSNESS”

Although defined clinically as a reversible physiologic change, manifest principally as an abolition of consciousness in the intact animal, it may nonetheless prove fatal.

PATHOLOGICAL BASIS NOT DETERMINED

The pathologic basis of this state continues to be disputed.
Claims for chromatolysis (type of nerve cell deterioration following injury or fatigue) of neurons of brain stem and cerebral cortex (outer, gray-matter portion of brain) for shattering of myelin sheaths (fatty substance around some nerve fibers) in the cerebral white matter remain unverified. There is a high degree of reversibility pathology located most.likely in the reticular formation of upper brain stem.

CONCUSSION: COUP AND CONTRECOUP

Difficulties in recognizing the morbid anatomy of concussion arise from the fact that reversible states nearly always reside in molecular or sub-molecular changes not to be seen with the light microscope, and also that increasing intensity of acceleration or deceleration of the unfixed cranium is attended regularly by another order of visible lesions, especially at the point of impact (coup) and opposite to it (contrecoup).

CHARACTERISTICS OF LESIONS

Cortical necrosis, hemorrhage from small “Vessels, and even laceration, characterize these lesions which are essentially contusions.

Traumatic Paralysis
Early functional deficits are traceable to traumatic paralysis (the pathological equivalent of concussion) and are highly reversible if time permits. Permanent residuals are due to sub-cortical tissue deficits, and to ischemic (deficient blood supply) lesions (infarcts) caused by compression of vessels and other herniations of brain.

EPIDURAL AND SUBDURAL HEMORRHAGES
Lesser degrees of injury, may tear dural arteries and subdural veins, resulting in epidural and subdural hemorrhages.
These may occur as isolated phenomena , or as part of the picture of more severe concussive types of cranial injury.
Surface bleedings create problems all of their own, related essentially to :

1) Cerebral displacement.
2) Herniation.
3) Arterial compression.
4) Secondary brain stem hemorrhages.

CAROTID ARTERY INJURIES
A special type of pathology is represented by trauma of the carotid artery or its branches. In some instances a dissecting aneurysm (deteriorating blister in wall of artery) may develop, leading to an immediate or delayed occlusion and massive infarction (scar formation) of a cerebral hemisphere.

Disability following head trauma and the objective evaluation of residual intellectual defect and subjective complaints of patients pose an increasing problem.

CLOSED HEAD INJURY WITH LOSS OF CONSCIOUSNESS
Although penetrating injuries of the brain cause many sequelae, the most formidable and yet often ill-defined problems follow closed head injury accompanied by loss of consciousness.  A Sacramento Head Injury Lawyer should be familiar with, and have a general understanding of the types of damage that can be caused by a closed head injury.

LOSS OF CONSCIOUSNESS AND DURATION OF POST-TRAUMATIC AMNESIA RELATED TO PROGNOSIS

Transient loss of consciousness due to concussion is followed by neuronal loss and structural damage, and the duration of loss of consciousness could be a measure of the degree of cerebral injury. The duration of post-traumatic amnesia in a patient with nonfocal closed head injury is directly related to the degree of structural alteration and therefore to the ultimate prognosis.

STRESSES ON BRAIN IN ACCELERATION OR DECELERATION CONCUSSION
Among tho serious stresses on the brain in acceleration concussion are the brain’s own inertia under conditions of excessive acceleration or deceleration and largo strains with shearing near the junction between the white and gray matter resulting from their different densities.

SYMPTOMS FOLLOWING POST-TRAUMATIC AMNESIA
The symptoms that continue after the conclusion of post-traumatic amnesia are mainly subjective:
1) Anxiety.
2) Irritability.
3) Difficulty with sustained mental concentration.
4) Impaired memory.
5) Excessive liability to fatigue.

I’m Ed Smith, a Sacramento Brain Injury Lawyer,  I’ve been handling  auto accidents and personal injury cases in Sacramento since 1982.

If you or someone you love has been injured in an automobile or motorcycle accident due to the negligence of another,  call me right away at (916) 921-6400 for free, friendly advice at no obligation to you.

If you are outside Sacramento, call us toll free (800) 404-5400.

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