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What is Traumatic Brain Injury?

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Traumatic Brain Injury (TBI) is referred to as the silent epidemic of modern times. Brain injury survivors are sometimes known as the walking wounded because their injury is not visible to those around them. In fact, many times their injuries go undiagnosed and therefore untreated. TBI symptoms include:

·         Headache

·         Dizziness

·         Irritability

·         Impaired Concentration or Inability to Focus

·         Depression

·         Anxiety

·         Malaise

·         Fatigue

·         Intolerance to Noise or Light

·         Emotional Lability or Mood Swings

·         Memory Loss

·         Sleep Disturbance

·         Personality Changes

More attention has been given in recent years to the significance of traumatic brain injury due in part to an increased awareness of sports concussions and the trials and tribulations experienced by US troops who sustained concussive force or blast injuries while serving in the Iraq and Afghanistan wars.

According to the Centers for Disease Control and Prevention, each year there are more than 2.8 million TBI-related emergency room visits, hospitalizations and deaths in the United States.  The major causes of TBI are motor vehicle crashes, falls, assaults and sports accidents.  Among all age groups, motor vehicle crashes are the third leading cause of TBI-related emergency room visits, hospitalizations and death.

Forces That Cause Traumatic Brain Injury

There are two types of traumatic brain injury, open head and closed head injuries.  An open head injury is a penetrating injury where the skull is breached.  A closed head injury occurs where there is no penetration or breach of the skull. For instance, a head that is subjected to rapid acceleration or deceleration, which often occurs in a motor vehicle crash.  In this motion, the brain impacts the front inside surface of the skull.  The head then snaps backward into the seat’s headrest where the brain then slams into the back inside surface of the skull.  This is known as a coup contrecoup injury and can occur with or without the head impacting a solid surface.

Closed head injuries can also be caused by rotational forces that result in shearing and tearing of the white matter tracts of the brain.  These types of brain injuries are referred to as diffuse axonal injury (DAI).

The grey matter in the brain is made up of cell bodies, dendrites and axon terminals of neurons.  White matter is made up of axons connecting different parts of grey matter in the brain to each other.

Mild, Moderate and Severe TBI

Traumatic brain injuries are typically classified as mild, moderate or severe.  Do not be misled, however, by the term “mild traumatic brain injury.”  This classification is generally based solely on the patient’s initial assessment in the emergency room and the potential for the injury to result in death.  The “mild” classification is not intended to speak to or describe the long-term consequences of the injury to the individual.  The American Congress of Rehabilitation Medicine defines a “mild” traumatic brain injury as an injury resulting in any period of loss of consciousness (but not more than 30 minutes), any loss of memory for events immediately before the accident, or any alteration of mental state at the time of the accident (confused, disoriented). It is now recognized by most medical professionals that an individual may suffer brain injury resulting in long term cognitive deficits without loss of consciousness.


Medical professionals diagnose brain injury through a neurologic examination and by brain imaging.  Doctors will obtain the patient’s history and review the patient’s complaints and symptoms.  A physical exam is administered to evaluate motor strength, reflexes, balance, gait and sensory and cranial nerve function; followed by a mental exam to assess the patient’s orientation to person, place and time, his memory and judgment.

Brain imaging usually begins with a CT scan in the emergency room.  Understand that CT scans are limited in detail and will typically only show fractures in the skull, bleeding or swelling of the brain or a shifting of the brain structures.  The principal benefit of the CT scan is that it is fast, relatively inexpensive and available in most emergency rooms.

An MRI (magnetic resonance imaging) uses powerful magnetic fields and radiofrequency pulses to produce far better detailed pictures (or slices) of the brain.  The MRIs used in most hospitals today use a 1.5 Tesla, which is the measurement of the strength of the magnet in the machine.  Research facilities more and more are using a 3T MRI which provides for a higher resolution of the machine and the ability to detect smaller and more obscure abnormalities or damage to brain tissue that may have been missed by a 1.5T MRI.

If you or your loved one have sustained a traumatic brain injury, call Paradowski Law and let us help you get what you deserve.

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