Common Brain Injuries: Diffuse Axonal, Lacerations & Hematomas (Extradural, Intracranial & Subdural)

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What are the common types of trauma to the brain?

The first type of trauma to the brain is called a diffuse axonal injury which is a big fancy word for saying that the cells get stretched when the brain gets shaken. The second type is lacerations. And the third is blood clots or hematomas.

The first type of injury is the most common one we see in our law firm. These are diffuse axonal injuries, also known as axonal shearing. Think of the brain like a bunch of pickles inside a jar, and when you shake that jar, it goes sloshing around into everything. And when that happens, when it's getting moved around so quickly, it causes the brain to be morphed. And when this happens, all of the axons, the brain cells that make up the brain, their little tails get pulled apart, and when that happens, it damages them. This type of injury is the most common in concussions, and really what it is, is that once the axons are sheared or stretched, the inflammation can cause cell death, which can cause memory loss and a lot of other different types of brain difficulties.

The second type of brain injury is a laceration which is another word for a cut. Lacerations are probably the rarest type of brain injury. They're seen most often in really traumatic accidents. A good example of a laceration is being shot in the head because the bullet itself is going to physically cut through the brain tissue. If someone has a skull fracture, oftentimes, an x-ray is done to investigate if any of the bony fragments have cut any of the blood vessels in the brain. It's a very serious type of brain injury. Not one that we see in our practice.

The third type of brain injury is blood clots which are similar to lacerations in that blood loss is an integral part of the entire process. Most of us are familiar with heart attacks and strokes. A heart attack is when the arteries around your heart get clogged by plaque which occurs in people with high blood pressure, and it leads to the heart not being able to do its job because the vessels are so clogged. A stroke is a very similar situation in the brain. You get one of the arteries clogged that provides the blood to the brain, which, of course, provides the oxygen the brain needs to perform its functions, and all of a sudden then the brain stops working, and it's an emergency medical condition.

There are three main types of blood clots. In the medical field, they're called hematomas. The first is known as an epidural or an extradural hematoma. This is when the blood accumulates between the skull and what's known as the dura. The dura is the outer layer of the brain. If you think about it, there are different levels and layers that we're gonna talk about within the brain and with these types of injuries. The first one is the highest layer. If you got a bruise on your head, then essentially you've got a hematoma that's just a blood clot above it. We've all had that. You bang your head, you get a little bump, it's a blood clot. It's a bruise for most of us, but when that bruise is between the skull and the brain, it's a lot more serious condition. That can create pressure on the brain that can lead to loss of oxygen in other areas of the brain. It can result in diminished brain function. It's most commonly associated with very, very severe headaches. This second type is an intracranial hematoma. When a blood vessel ruptures between the skull and the brain, but more inside the brain, inside of the actual membrane or the dura, this is an intracranial hematoma.

Most people, when they think of hematomas, are familiar with the subdural hematoma. This is the third type and these are the most dangerous form of hematoma. This occurs when the blood collects between the dura and the actual arachnoid layer of the brain, and really, that's just a fancy way of saying, essentially, within the brain matter itself. And that means that these can occur anywhere along the area, and when they occur, they can cut off blood flow. They can prevent certain areas of the brain from functioning, and they can cause a lot of pressure in the head, which again, is what causes most people to be aware of these. Subdural hematomas are the most common and serious type of hematoma that occurs in auto accidents.