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What is a Traumatic Brain Injury? The Basics Explained

By Matt Lalande in Brain Injuries, Hamilton Personal Injury Lawyer on February 15, 2024

What is a Traumatic Brain Injury? The Basics Explained

What is a Traumatic Brain Injury? The Basics Explained.

A traumatic brain injury (TBI) refers to a form of acquired brain injury resulting from a sudden trauma that damages the brain. This can happen through a direct blow in a motorcycle or car accidenttrucking accidentor bicycle or pedestrian accident. A traumatic brain injury can also be caused by a jolt to the head or body, an object penetrating the skull, or a blast injury disrupting the brain’s normal functioning. 

The severity of TBIs can range significantly, from mild concussions, characterized by temporary confusion or loss of consciousness, to severe injuries that may lead to prolonged unconsciousness, amnesia, or death. TBIs are known for their potential to cause a wide array of physical and psychological effects, some of which may manifest immediately after the incident, while others could emerge days or weeks later. 

These effects can include physical symptoms like headaches, dizziness, and nausea, cognitive impairments such as memory loss and difficulty concentrating, and emotional disturbances including mood swings and depression. The impact of a TBI can vary greatly depending on the location and extent of brain damage, making the prognosis and recovery process highly individualized.

Types of Brain Injury Explained

The most serious traumatic brain injuries (TBIs) involve conditions that typically result in significant long-term complications or death. Here’s a list of some of the most serious TBIs along with a short description of each:

Diffuse Axonal Injury (DAI): This type of injury occurs when the brain rapidly shifts inside the skull as a result of acceleration or deceleration, typically during a car accident or other high-impact events. It causes widespread damage to the brain’s white matter, leading to unconsciousness, coma, or even death due to the disruption of neural connections.

Penetrating Injury: A penetrating, or open head injury, happens when an object, such as a bullet or sharp object, breaks through the skull and enters the brain. This can cause severe damage to specific brain areas, leading to significant impairments or death, depending on the trajectory and speed of the object.

Contusion: A contusion is a bruise (bleeding) on the brain, often resulting from a direct impact on the head. Large contusions may need to be surgically removed if they lead to increased pressure on the brain which can be life-threatening.

Coup-Contrecoup Injury: This occurs when the force impacting the head is not only strong enough to cause a contusion at the site of impact but also on the opposite side of the brain. This happens because the impact causes the brain to move inside the skull, hitting the skull on the opposite side, leading to contusions at both the site of impact and its opposite.

Second Impact Syndrome (SIS): Although rare, SIS can be fatal. It occurs when a person sustains a second traumatic brain injury before the symptoms from an earlier TBI have subsided, leading to rapid and severe brain swelling. SIS can result in catastrophic neurological impairment or death.

Traumatic Subarachnoid Hemorrhage (tSAH): This type of injury involves bleeding into the space surrounding the brain, known as the subarachnoid space. It can increase pressure on the brain, leading to severe complications, including stroke, brain damage, and death.

Intracerebral Hemorrhage: This is bleeding within the brain tissue itself, often caused by a severe head injury. It can lead to increased pressure inside the skull, causing brain damage or death. Immediate medical intervention is critical to manage the pressure and mitigate damage.

These types of TBIs are among the most critical and require immediate medical attention to minimize long-term damage and save lives. The prognosis for each type can vary widely depending on the severity of the injury, the promptness of treatment, and the individual’s overall health.

Signs and Symptoms of Traumatic Brain Injury

The signs and symptoms of a serious traumatic brain injury (TBI) can vary widely depending on the severity of the injury and the area of the brain that’s affected. However, some common signs and symptoms are particularly indicative of a more severe TBI. These include:

Loss of Consciousness: This can range from a few minutes to several hours, and in very severe cases, the person may not regain consciousness (coma).

Persistent Headache or Headache that Worsens: A continuous headache that doesn’t go away or gets worse over time can be a sign of a serious condition.

Repeated Vomiting or Nausea: Frequent vomiting or nausea is a common symptom following a significant head injury.

Convulsions or Seizures: The occurrence of seizures following a head injury can indicate severe brain damage.

Dilation of One or Both Pupils of the Eyes: Unequal pupil size can be a sign of serious brain injury.

Clear Fluids Draining from the Nose or Ears: This can indicate a fracture in the skull and a potential leakage of cerebrospinal fluid.

Inability to Awaken from Sleep: A person who cannot be awakened after sleeping following a head injury may have a serious TBI.

Weakness or Numbness in Fingers and Toes: Weakness or numbness in the extremities can be a sign of brain damage affecting the neural pathways.

Profound Confusion: Difficulty thinking, attention deficits, or confusion about events, people, or places can be a sign of serious brain injury.

Agitation, Combativeness, or Other Unusual Behavior: Behavioral changes, including agitation, combativeness, or even a sudden personality change, can indicate a severe TBI.

Slurred Speech: Difficulty speaking or slurred speech can be a symptom of brain damage affecting speech centers.

Difficulty with Coordination or Balance: Problems with coordination or balance can indicate damage to the parts of the brain that control these functions.

These symptoms require immediate medical attention as they may indicate serious brain injury and the need for urgent care. Early medical intervention can be critical to outcomes, potentially mitigating long-term effects and improving the chances of recovery.

Long-Term Effects of Serious Traumatic Brain Injury

People who survive a traumatic brain injury can face a lifetime of disruptions and impairments. 

Research generally indicates that brain tissue, once damaged or destroyed, cannot grow back. In many cases, the injured person is unable to recover completely. The result may mean a reduced capacity for the rest of the injured person’s life. This can mean slow thinking and memory loss that affect your ability to continue work. Or, it can mean personality changes that cause pain and suffering in your personal relationships. Physical impairments that include paralysis of parts of the body can also be a long-term result. 

Treatment and recovery from a traumatic brain injury are often a long and expensive ordeal. In many cases, a brain injury victim will never be the same. These long-term effects can include memory loss, chronic pain, alteration to a sense of smell or taste, hearing loss, and weakness or paralysis on one or both sides of the body. 

People suffering from TBI may need financial compensation to cover lost wages, medical care, and assistance with day-to-day tasks as a result of their injury. 

The value of a skilled and experienced brain injury lawyer cannot be overstated. If someone is faced with a life of reduced capacity and expanded expenses due to someone else’s negligence, it is vital to have someone fighting for you. A lawyer experienced in brain injury cases can pursue damages to cover future needs.

Car Accident and No-Fault Benefits

If you or your loved one suffered a brain injury in a car accident, or any type of motor vehicle accident, it is important that you contact a brain injury lawyer to discuss your rights. In Ontario, the insurance laws, especially in the context of car accidents leading to traumatic brain injuries (TBIs), are extremely complex and can be daunting for individuals already coping with the consequences of a TBI. 

Our experienced brain injury lawyers understand the nuances of Ontario’s insurance regulations, including statutory accident benefits, tort claims, and the categorization of injuries as minor, non-catastrophic, or catastrophic. 

An experienced car accident lawyer can advocate on behalf of the victim, ensuring that their rights are protected and that they receive the fullest compensation possible under the law, thereby allowing them to focus on their recovery.

It’s important to recognize that a traumatic brain injury is a medical term, while a catastrophic brain injury is a legal term. In Ontario, anyone suffering an injury in a motor vehicle accident – whether a pedestrian, in a car, or on a bicycle, is entitled to “accident benefits”. Accident benefits are set out in a schedule (SABS) which provides benefits an accident victim is entitled to, as well as how to apply for them and dispute their denial. Again, Ontario’s accident benefits regime is complex, highly regulated, and subject to periodic change – which is why you need a qualified brain injury lawyer to help you navigate the process. 

Accident benefits are subdivided into three major categories – a chart can be found here.  The categories are set out as minor injuries, In Ontario, accident benefits are categorized by injury severity: minor, non-catastrophic, and catastrophic, each with specific monetary limits. 

Minor injuries – including sprains and whiplash, receive up to $3,500 in medical and rehabilitation benefits. 

Non-catastrophic injuries – offer up to $65,000 in combined medical, rehabilitation, and attendant care benefits for up to five years, unless the injured person is a minor or a student. 

Catastrophic injuries – such as severe brain or spinal cord injuries, provide up to $1 million in combined medical, rehabilitation, and attendant care benefits over a lifetime. This system ensures financial support aligns with the care needed for recovery based on injury severity.

The law states that a victim cannot be declared catastrophically impaired until two years after the accident. However, if one’s brain injury is serious enough, your brain trauma lawyer can apply to have you declared catastrophically impaired immediately, allowing your family to access the $1M in enhanced benefits right away for life (up from the available $65,000 for 5 years). 

Catastrophically Impairment – When and How

In Ontario, for individuals aged 18 or older at the time of an accident, the criteria for being catastrophically impaired due to a traumatic brain injury are specific and detailed. 

Firstly, the injury must be verified by brain imaging technologies such as a CT scan or MRI, showing clear signs of brain damage related to the accident, including but not limited to contusions, hemorrhages, diffuse axonal injury, swelling, midline shift, or pneumocephaly. 

Secondly, the severity of the injury is assessed using the structured interviews for the Glasgow Outcome Scale (GOS) and the Extended Glasgow Outcome Scale (E-GOS), as outlined by Wilson, Pettigrew, and Teasdale in the Journal of Neurotrauma.

Based on this assessment, the injury is classified into several categories based on the time elapsed since the accident and the level of disability:

  • Vegetative State (VS): If the individual is in a vegetative state one month or more post-accident.
  • Severe Disability (SD): This is further divided into Upper Severe Disability (Upper SD) or Lower Severe Disability (Lower SD) if this state persists six months or more after the accident.
  • Moderate Disability (MD): Specifically, Lower Moderate Disability (Lower MD), if this condition is present one year or more following the accident.

This classification system is designed to identify those who have sustained extreme brain trauma, reflecting the significant and long-term impact on their lives and necessitating a higher level of support and benefits under Ontario’s accident benefits schedule.

Our Brain Injury Lawyer in Hamilton Can Help your Family. Call us Today.

After a life-altering injury, you may feel helpless and overwhelmed – worried about your loved one and where their lives are heading, how they will be taken care of, and how much it will cost. No doubt caring for a person with an extremely serious brain injury in Ontario can incur exorbitant expenses, encompassing long-term medical care, rehabilitation services, and personal support needs, which can place a significant financial burden on families and the healthcare system. The comprehensive care required for such injuries often involves specialized treatments and therapies, making it a financially challenging journey for all involved.

We’ve represented hundreds of brain injury victims, and we are prepared to help your family recover the compensation you deserve. If your loved one has been hurt in a car accident – or any type of motor vehicle accident – call us today, no matter where you are in Ontario at 1-844-LALANDE or local throughout southern Ontario by calling us at 905-333-8888. You can also send us confidential email through our website or chat with us live 7 days a week, 24 hours a day. Lalande Personal Injury Lawyers are here to help you recover justice in your time of need.

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