By Matt Lalande in Brain Injuries on March 04, 2022
A diffuse axonal injury (DAI) is a type of closed-head traumatic brain injury (TBI) that results from a blunt injury to the brain. They are often caused in serious car accidents, pedestrian accidents, motorcycle accidents, trucking accidents and bicycle accidents. This type of brain injury is common and one of the most devastating.
The most significant cause of damage in a DAI is the tearing or shearing of axons. Axons are the neural processes that allow neurons to communicate with one another. The injury is characterized by extensive generalized damage to the “white matter” of the brain that often occurs during high-speed acceleration, deceleration, or rotational forces.
It is a terrible type of brain injury that can cause cognitive, physical, and behavioural changes. The results of this injury often compromise a person’s social reintegration, return to productivity, and quality of life.
A diffuse axonal injury falls under the category of a “diffuse” (or spread) brain injury. This means that instead of occurring in a specific area, like a focal brain injury, the shearing of axons happen over a more widespread area.
Diffuse axonal injury, and more generally TBI, often results in physical, cognitive, and behavioral impairments that can be temporary or permanent.
Diffuse axonal injury (DAI), also known as shear injury or traumatic axonal injury, refers to intracranial injury caused by rapid and sustained deceleration or acceleration of the brain.
An intracranial injury is a head injury that exists or occurs within the cranium – in other words, a closed head injury.
A diffuse axonal injury is normally diagnosed by MRI.
diffuse axonal injury is a serious brain injury, and every person’s case is unique. However, as a medical term, there are categories and levels of diffuse axonal injuries, ranging from being completely comatose (extremely severe) to having a concussion, for example (less severe).
There are two types of brain injuries: traumatic and non-traumatic. A traumatic brain injury (TBI) occurs when a hard blow to the head causes brain damage. A traumatic brain injury can range from a low-level concussion to severe brain damage. The impact can be from a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.
Signs and symptoms range in severity, ranging from loss of consciousness (LOC) lasting a few seconds to seizures, coma, or even death. Severe traumatic brain injuries can lead to chronic debilitating conditions, which can also have acute and chronic outcomes for both the victim and their families and caregivers.
There are many different types of traumatic brain injuries often seen by our Hamilton brain injury lawyers, including:
Concussions:
The term “concussion” comes from the Latin concussio —meaning “to strike together” – Concussion are often diagnosed as mild traumatic brain injuries, without any structural damage. A concussive injury can leave an individual with different levels of altered mental states. This can range from mild confusion to complete unconsciousness for a few minutes. The prognosis is usually good, and most patients experience complete resolution of symptoms.
Cerebral Contusions:
Cerebral contusions are a form of brain tissue bruising. They can be caused by multiple micro hemorrhaging or small blood vessels that leak into the brain tissue. They are often caused by direct blows to the head and commonly occur due to localized trauma along the frontal and temporal lobes of the brain. Cerebral contusions usually heal on their own without ongoing medical treatment or intervention.
Intracerebral Hemorrhage:
This is a common type of injury our Hamilton brain injuries lawyers see after a car accident. Blood vessels, such as arteries and veins, carry blood to and from the brain. In a serious accident, these blood vessels may be damaged and rupture, causing bleeding into the brain tissue. While high blood pressure is an extremely common cause of intracerebral hemorrhage, it can also be caused by a traumatic brain injury. Often, surgery is required to relieve pressure on the brain and repair torn arteries.
Subdural Hematoma:
This occurs when blood builds up on the brain’s surface, particularly in the space between the protective layers surrounding your brain. When this happens, blood leaks out of torn vessels into the space below, called the “dura matter.” Dura matter is the membrane between your brain and your skull bone. It is technically the type of brain bleed that occurs inside your cranium but outside your brain.
It is reported that subdural hematoma can happen in up to 25% of victims who suffer serious head injuries. Surgery may be required to relieve pressure in the brain and drain the blood, reducing the pressure that the buildup causes onto the brain itself.
Epidural Hematoma:
Epidural hematomas can be life-threatening. Typically, they require immediate medical attention, as the brain can suffer severe brain damage or possibly death. An epidural hematoma is the build-up of blood between the skull and the “dura matter,” the brain’s most productive member.
In most cases, a craniotomy or hematoma evacuation is necessary. This is a type of surgery in which a piece of the skull is removed, and any obvious signs of bleeding are stopped or slowed. Other types of surgery would include drilling one or more holes in the cranium to relieve pressure and drain the blood.
Intraventricular Hemorrhage (IVH):
Intraventricular hemorrhaging is bleeding inside or around the ventricles in the brain, which are the spaces that contain the cerebral spinal fluid. It can occur during a traumatic birth or from complications after delivery. The condition is most often seen in premature babies, and the smaller and more premature the infant, the higher the risk for IVH.
Traumatic Subarachnoid Hemorrhage:
This is when blood that escapes from a ruptured blood vessel leaks into the space surrounding the brain, which is described as a subarachnoid hemorrhage. The subarachnoid space is the fluid-filled space around the brain between the arachnoid membrane and the pia mater (the delicate innermost membrane enveloping the brain and spinal cord) through which major blood vessels pass.
The cerebrospinal fluid in this space forms a floating cushion the brain hovers in for protection. When an injury causes some small arteries to tear, the blood flow spreads all over the brain’s surface, causing widespread traumatic effects.
Diffuse Axonal Injury:
As mentioned, a DAI is a severe and life-threatening form of brain injury. Axons, which compose what is also known as the brain’s white matter, connect nerve cells throughout the brain. When the brain reverberates (quickly moves back and forth inside the skull), the nerve axons can be torn and damaged.
During car accidents, for example, the rapid rotation or deceleration of the brain causes stretching of these nerve cells on a cellular level. The brain’s normal transmission of signals (information) is disrupted, dramatically impacting an individual’s alertness and wakefulness.
Diffuse axonal injuries are often called “shear injuries” and are one of the most frequent types of primary brain injury that our Hamilton brain injury lawyers see in car accidents. The blunt trauma to the brain causes the brain’s axons to stretch and tear. Axons are microscopic nerve fibres that are found within the inner part of the brain, known as white matter.
The stretching of the axons occurs because the unmoving brain lags behind the movement of the skull, causing nerve structures to tear. The carrying of the axons then disrupts the brain’s regular communication and chemical processes. This can lead to permanent and widespread brain damage or even death.
Unfortunately, diffuse axonal injuries often see very poor clinical outcomes. Many victims go on to suffer severe verbal short-term memory, frontal lobe cognitive dysfunction, slowed information processing and, overall, long-lasting neuropsychological impairments to the memory and executive functioning of the brain.
Unfortunately, many individuals who suffer diffuse axonal injuries do not survive. Victims suffering from diffuse axonal brain trauma who survive often suffer cognitive, physical, and behavioural changes that can be temporary or permanent.
In some cases, the brain may gradually return to normal function. This is because brain tissue is functionally impaired and not destroyed with diffuse axonal injuries.
Individuals who do not fully recover often suffer from cognitive deficits, such as memory problems, judgement issues, forgetfulness, and issues concentrating. Victims may also suffer sensory deficits, such as vision challenges and depth perception problems. They can also suffer from communication and language difficulties, such as difficulty speaking, word-finding problems, stuttering, hesitant speech, and decreased vocabulary.
Other types of issues include functional deficits, such as the impaired ability to maintain regular daily activity, organizational challenges, trouble being in the community, issues driving, etc. Victims with diffuse axonal injuries can also suffer from impaired social capacities and damaged interpersonal relationships, as they can miss social cues and have difficulties understanding and responding to the nuances of social interactions in general.
Victims with diffuse axonal injuries can also suffer from ongoing mood issues such as anger, irritability, anxiety, depression, disinhibition, fatigue and, in severe cases, traumatic epilepsy.
Often, people who suffer ongoing permanent issues due to brain trauma caused by diffuse axonal injury (and, of course, depending on the severity) will require either temporary or permanent ongoing brain injury rehabilitation. Clinical providers will be required to help maximize a brain injury victim’s capabilities both in their home and in the community. Psychological treatment is also typically required, as are the services of occupational and speech therapists.
Depending on the severity of the diffuse axonal injury, individuals may also need various brain injury treatment plans for acute management, community rehabilitation, behavioural management, and assistance with independent living.
Our Hamilton brain injury lawyers often witness the heavy financial burdens that follow when individuals are injured in an automobile accident. When the driver is not responsible for a car accident, they and their passengers may be able to recover compensation from the at-fault driver and their insurance company.
However, auto litigation in Ontario can take years before liability is established and trials or settlements are reached. In the meantime, ongoing medical and rehabilitation expenses may need to be paid.
As part of a standard auto policy in Ontario, accident benefits are provided to policyholders injured in car accidents. If you pay for an auto insurance policy in Ontario, accident benefits are payable to you as a hurt victim regardless of whether you were driving or not at the time of the accident.
You are entitled to claim accident benefits if you are a passenger, pedestrian, or cyclist. If you do not have an auto insurance policy, you are entitled to claim accident benefits from the auto policy belonging to the at-fault driver that caused your accident. Accident benefits can provide critical relief from a financial and rehabilitation perspective immediately after an accident.
Motor vehicle accident victims who suffer severe brain trauma are entitled to claim medical and rehabilitation benefits as well as attendant care benefits to assist them with reintegration into the life they once knew. The medical, rehabilitation, and attendant care benefits vary significantly depending on the severity of one’s injuries.
For example, people who suffer serious orthopedic injuries or minor brain trauma causing severe psychological or cognitive issues are eligible to receive up to $65,000 in medical, rehabilitation and attendant care benefits. Attendant care benefits are payable up to $3000 a month.
In certain circumstances, individuals are entitled to enhanced benefits up to $1 million for life. These benefits are reserved for the most seriously injured claimants, such as victims who suffer severe traumatic brain injuries or who become paralyzed. These victims have access to the broadest array of accident benefits.
Within the statutory accident benefits schedule, there is a definition of catastrophic impairment regarding those over 18. Some of the criteria include:
It is essential to get in touch with a Hamilton brain injury lawyer early. Our brain injury lawyers can help you determine whether your injury is categorized as catastrophic, which dictates the benefits you will apply for.
Often, this will require medical imaging, including a computerized axial tomography scan, magnetic resonance imaging or any other medically recognized brain diagnostic technology indicating intracranial pathology resulting from the accident. This can include but is not limited to intracranial contusions or hemorrhages, diffuse axonal injury, cerebral edema, midline shift or pneumocephaly. If catastrophic impairment can be determined, you or your loved one will be eligible for enhanced accident benefits of $1,000,000 for life.
If your loved one has suffered a serious traumatic brain injury – or, in particular, a diffuse axonal injury caused by a negligent third party, our Hamilton brain injury lawyers can help. We offer free consultations wherein we will discuss your situation in detail and provide our best legal advice. No payment is required upfront, and our consultations are free of obligation.
Our Hamilton brain injury lawyers are familiar with the devastating pain, suffering, and life changes that can accompany severe and traumatic brain injuries. We know that no amount of money can reverse the injury or the suffering you’re experiencing. Still, financial assistance can significantly reduce the stress and overwhelm that often comes with these injuries. It also ensures that you or your loved one receives the best care to aid in the fullest recovery possible and the best quality of life moving forward.
Call us no matter where you are in Ontario at 1-844-LALANDE (525-2633) or local in the Hamilton / Burlington / Niagara areas at 905-333-8888tell. Alternatively, you can reach us by sending an email through our website and someone will get back to you promptly.
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