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Brain Injuries: Contusions, Concussions and Post-Concussive Syndrome.

By Matt Lalande in Brain Injuries on August 14, 2021

Brain Injuries: Contusions, Concussions and Post-Concussive Syndrome.

It can happen in the blink of an eye. In one instant your life can be forever changed. It may have been caused by a fall, a car accident, motorcycle accident, trucking accident or being hit by a car. Recovering from mild traumatic brain injury (MTBI) is a new experience not only for those who are injured but also for those caring people who want to help.

A mild traumatic brain injury (MTBI) is defined as a blow or jarring of the head that results in a disruption of brain functioning. Mild traumatic brain injuries are normally called “closed head injuries” because there is a non-penetrating injury to the brain. This type of injury can be caused by whiplash, a blast injury, or hitting the head, resulting in bruising, stretching, and shearing of the axons and/or tearing of the tissues. 

A brain bruise, contusion, or concussion may seem like a mild injury, and typically it will be. However, any injury involving the brain has the potential to cause substantial damage if it does not heal properly or if it does not receive immediate treatment. 

The first step in recovering from any type of brain injury, even if it doesn’t seem severe, is understanding the specific type of injury it is. There are a variety of potential head and brain injuries that may occur after an accident, and some sound strikingly similar. To make matters more complicated, some of these brain injuries share similar symptoms; as a result, it can be difficult to diagnose without further testing. 

Remember – if you or your loved one has suffered a mild traumatic brain injury and your symptoms are left permanently unresolved, we can help. From what we have learned, approximately 50% of persons with a mild traumatic brain injury going to suffer permanent residual symptoms such as blurred vision, dizziness, fatigue, headaches, concentration issues, forgetfulness, sleep disruption etc. As Hamilton brain injury lawyers that have worked with victims of serious head trauma since 2003, we cannot stress enough how dangerous undiagnosed or untreated head injuries can be.

What are Brain Bruises (Cerebral Contusions)?

A cerebral contusion, or brain bruise, occurs when blood vessels rupture in the brain, causing a collection of blood to form inside the skull and bruising to form directly on the brain. These bruises can lead to swelling and bleeding within the brain.

For a person to suffer brain injury, the skull does not have to be fractured. The impact of the blow to the head can cause your brain to crash against the inside of your skull repeatedly as it moves back and forth. The impact can then cause bleeding bruising and tearing of nerve fibers. The resultant bruising can cause temporary dysfunction of the brain, meaning that the brain will not work as well as it is supposed to for a while.

While more than 95% of people recover from serious brain bruising within a month, there are some that do not. Some people will go on to suffer permanent complications and difficulties such as attention issues, concentration issues, short-term memory loss, planning and organization difficulties etc. Overall, the people that suffer permanent residual brain dysfunction will find that their brains feel slower and that the symptoms will be enhanced when a person is tired, under pressure, stress or worry.

Most minor contusions will heal on their own, but a medical professional may advise treatment aimed at reducing the swelling or monitoring blood pressure and carbon dioxide levels in the blood. In some cases, surgery may be required to reduce the intracranial pressure on the brain.

What is a Concussion?

Technically, a mild traumatic brain injury is simply another name for a concussion. A concussion is a very common type of traumatic brain injury that is caused by car accidents (particularly rear-end collisions), slip and falls, bicycle accidents, pedestrian accidents, and motorcycle accidents, among many others. According to Brain Injury Canada, there are approximately 200,000 concussions in Canada every year.

Again, the skull does not have to be fractured in order for the brain to suffer damage – nor does loss of consciousness. In fact, no physical sign of a head injury has to be present.

A concussion is normally caused by rapid acceleration or deceleration of the brain, after the skull gets impacted in one way or another or there’s a sudden change of direction the causes the brain to move rapidly within the skull. Then, the result is that, like brain bruising, there is a temporary disruption in brain function – and the brain will not work like it’s supposed to for some time. Again, many if not most people recover from concussions and concussion like symptoms but there are some that don’t. For a small percentage of people that experience serious concussions, symptoms could end up being permanent. When this happens, this is when you should call a brain injury lawyer to discuss your options.

What is post-concussive syndrome?

A neuropsychiatrist that we often deal with tells us that post-concussive syndrome is part of the healing process and often is no need to worry. The common symptoms of post-concussive syndrome our attention deficit, confusion, depression, disrupted sleep, exhaustion, forgetfulness, headaches, impaired vision, moodiness, nervousness, sensitivity to light and vertigo.

What are Intracerebral Hematomas?

Intracerebral Hematomas are very serious. Ruptured blood vessels in the brain cause bleeding, which naturally clots. Sometimes these hematomas are very small. However when a hematoma is large, it may compress the brain. Symptoms will depend on the location of the hematoma and are named for their location. For example, a hematoma that forms between the skull and the membrane that wraps around your brain, is called an epidural hematoma. When a hematoma performs deep inside of the brain, it’s called an intracerebral hematoma.

We are told that under fortunate circumstances, the body will reabsorb the hematoma. However, large clots or hematomas often have to be removed by surgery.

What is The Difference Between a Concussion and a Contusion?

While the names of these injuries sound similar, and they are both caused by trauma, they are very different. The key difference is that a contusion is typically concentrated in one area, usually the area where the trauma occurs, while a concussion is larger and impacts a bigger area of the brain. Further, contusions tend to be more minor than concussions, but both can become serious.

Contusions and concussion are related in that, like most head injuries, they pose a risk of bleeding in the brain. This is dangerous because blood is extremely toxic to the brain. The central nervous system contains the blood–brain barrier, which prevents toxic substances from reaching the brain via a thick wall that separates blood vessels from the other cells contained within the brain’s tissues. 

The blood-brain barrier only allows essential nutrients to reach the brain, and when blood penetrates this layer, the brain is unable to filter it out. As a result, blood cells die and break down, but cannot be expelled causing swelling, pressure, and hemorrhaging that could lead to infection, brain damage, or death.

What are the Other Types of Head Injuries?

Concussions, contusions, and blood clots are very common head injuries, but they are just a few on the long list of potential head trauma one may experience after an accident. 

Skull fractures: While the skull has a very important job to do in housing and protecting the brain, it is not invincible and can be subject to breakage after high-impact trauma. Broken skull bones, or skull fractures, can pierce the brain, which leads to bleeding or hemorrhaging.

There are four main types of skull fractures. These are:

  • Linear skull fractures (minor fractures that occur when the skull bone breaks but does not move)
  • Depressed skull fractures (fractures that cause the skull to sink in, typically requiring surgical intervention)
  • Diastatic skull fractures (fractures along the suture lines of the skull)
  • Basilar skull fractures (severe fractures that occur at the base of the skull)

Cerebral lacerations: A laceration occurs when brain tissue is torn, typically from a skull fracture or from a sharp object piercing the brain.

Intraparenchymal hemorrhage: This occurs when there is bleeding inside of the brain, and is sometimes presented as a complication from another head injury.

Subarachnoid hemorrhage: Usually occurring alongside a contusion, a subarachnoid hemorrhage happens when blood leaks into the fluid that covers the brain, known as cerebrospinal fluid (CSF). Non-traumatic causes, such as aneurysms, may also cause this injury.

Diffuse axonal injury (DAI): A DAI is similar to a concussion in that it’s caused by forceful shaking of the head. However, a DAI is often severe and results in loss of consciousness or a comatose state, which can lead to prolonged damage to the brain. This type of injury is also known as shaken baby syndrome in newborns and infants.

Signs You May Have a Head Injury 

As we mentioned above, while these head injuries are different in nature, some share similar symptoms. It’s important to be on alert for these symptoms within a few days of an accident or injury, and seek medical attention immediately when you begin to notice them. In some cases, these symptoms may become long-term complications that have permanent effects.

If you or a loved one has recently been involved in an accident and you are concerned about potential head injuries, here are some signs you should be on the lookout for:

  • Headache 
  • Loss of consciousness 
  • Nausea and/or vomiting 
  • Confusion or disorientation 
  • Difficulty concentrating or focusing 
  • Double vision or blurred vision 
  • Ringing in the ears 
  • Increased sensitivity to light or sound 
  • Fatigue 
  • Lightheadedness
  • Behavioural changes, such as agitation
  • Difficulty with balancing and/or coordination
  • Memory issues 
  • Weakness or loss of strength
  • Dilated pupils 
  • Impaired senses (such as lack of smell or taste)

When symptoms of brain trauma are seen after an accident, it is of paramount importance to seek medical attention immediately from your primary health care provider or through emergency care, even if symptoms are mild. Closed head injuries can result cause the brain to impact against the inside of the skull repeatedly, in turn causing bleeding bruising and tearing of nerve fibers. Without medical attention, these injuries can progress and cause further brain damage, disability, or death.

Contact our Hamilton Brain Injury Lawyers

If you plan on filing a personal injury claim for the traumatic brain injury you have suffered, it’s important to contact a Hamilton personal injury lawyer as soon as you can. Matt Lalande has worked extensively across Ontario with victims of severe head trauma, traumatic brain injuries, and other catastrophic injuries since 2003. He has collected a vast knowledge of these injuries and the devastating impact they can have for victims, as well as their loved ones.

Even if you are not entirely sure if you have a case, there is no risk in speaking to a lawyer to get advice about your specific situation. All of our consultations are free, with no upfront charges, and no obligation to retain our services after we meet. We only represent victims, and we operate on a contingency basis. That means we don’t charge you anything up front, and if you don’t win your case, you don’t get a bill.

Book your free consultation using our online contact form, or by calling us toll-free at 1-844-LALANDE (1-844-525-2633). You can also reach us in the Hamilton/GTA/Niagara region by calling us at 905-333-8888. We are always happy to speak to people about their injury and experiences and remember, our firm never asks clients for money upfront.


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LALANDE PERSONAL INJURY LAWYERS  – HAMILTON OFFICE
1 King Street East, Suite 1705
Hamilton, On L8P 1A4
Local: 905-333-8888
Toll Free: 1-844-LALANDE


This post was researched by review of pubmed articles, Brain Injury Medicine: Principles and Practice (Nathan D. Zasler MD, Douglas I. Katz MD. Ross D. Zafonte DO) and in with our brain injury experts retained on files.

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