Probably the most devastating injury for humans is one to the brain – a common injury in car accidents and motorcycle accidents. For those not wearing a seat belt, a frontal collision will nearly always cause the head to be driven forcefully into the windshield or steering wheel, resulting in a brain injury. Newer car windshields are a bit elastic, and will absorb some of the energy, but even that is insufficient to protect the brain from being slammed against the inner surface of the skull. Surprisingly, the opposite side of the brain may also be injured, as it is pulled away from the skull. Not only may the impact cause brain injury, but the bleeding that can result from fractures that tear blood vessels may also put pressure on the brain (hematoma), causing additional damage. The front of the brain, as well as the sides of the brain, tend to be damaged most often, since those are the parts most likely to collide with rigid structures inside the skull.
Bleeding between the skull and the brain or bleeding inside the substance of the brain is especially dangerous, since there may be a delay of hours or days before it occurs. Bleeding exerts pressure throughout the brain, since the skull is a closed box. It may shift the brain to one side or interfere with the normal absorption of spinal fluid. Although it can be typically be corrected by surgery, delays in detection may lead to additional permanent brain injury or death.
How Brain Injury Often Occurs
Motorcyclists and bicyclists who do not wear helmets are especially vulnerable to brain injuries, sometimes with crushing injuries to the skull, where fragments of bone or metal are thrust into the cortex of the brain. Whiplash injuries, where the neck is violently thrown to and fro (flexed and extended), may damage the nerves running into the central part of the brain, primarily from stretching of these critical nervous pathways. Airbags have been wonderful in diminishing the frequency of brain injuries, and many newer cars can be bought equipped with side-impact air bags, another fabulous innovation.
Obviously, the brain can be injured by a blow to the head from other causes, such as with a baseball bat, or from a fall from a roof or ladder.
Diagnosing Brain Injury
Not infrequently, the victim is unconscious after the collision, and may remain unconscious after arrival at the emergency department. The length of time the victim is unconscious usually correlates directly with the severity of the brain injury. Accurate neurological evaluation is often difficult in the comatose patient. One cannot easily tell if the arms and legs are still properly wired to the brain. CAT Scans and MRIs may not reveal damage to the deeper parts of the brain, especially the stretching injuries to the more central nerves. At the time of initial evaluation in the emergency department, unstable fractures of the neck (cervical spine) are missed with alarming frequency, even by mostly-competent physicians. These neck injuries are frequently associated with bruising (contusions) of the brain, detected or not. Even when a victim is unconscious for a relatively short period of time, there may well be significant damage to the brain.
Effects of Brain Injury
The effects of brain injury are many, and may include personality changes, inappropriately aggressive behavior, significant memory loss, persistent anxiety, frequent mood swings, sexual dysfunction and loss of libido, dizziness and chronic headaches, disorientation and forgetfulness, inability to sleep and chronic depression. More specific deficits may include weakness or paralysis of either arms or legs, and loss of bladder or bowel control. Seizures may develop, either big ones, where the patient becomes unconscious and shakes all over, or peculiar ones, where she simply stares or twitches. Sometimes the symptoms will resolve with time, but often they are permanent manifestations of significant brain injury. Brain injury rehabilitation is especially frustrating for patients and physicians alike, since the brain is resistant to regeneration, and improvement is slow. New brain pathways can be developed to relearn many skills, but this is a time-consuming task.
Contact a Lawyer About Your Brain Injury
If you have suffered a brain injury as a result of a car accident or negligence of others, Parker Scheer recommends that you consult with a personal injury lawyer and evaluate your case. For your free confidential case review click here and receive a response from one of our attorneys within hours. If you prefer, you can also telephone our offices in Boston seven days a week at toll free .