- Types, causes, and symptoms of traumatic brain injury
- Identifying traumatic brain injury by cause, spread and severity
The classification of traumatic brain injury (TBI) is a vital step in diagnosis and treatment, and often plays a key role in legal investigations following the event. TBI can be classified three ways: by cause, by location, and by severity.
Classifications by cause
While TBI generally results from external force, the injury itself doesn’t always occur immediately after the impact. When the brain is injured on contact, the TBI is referred to as primary. Primary TBI can result from skull fractures, scalp injury, and surface contusions. Sudden acceleration-deceleration, common in motor bicycle accidents, can also cause the brain to move around in the skull, leading to TBI.
Secondary TBI can occur as late as several days after the accident. In this case, the injury is caused by impairment or hemorrhage in another area, which may limit blood flow to the brain, put increased pressure on the skull, or both.
Classifications by location
A relatively new classification method, this actually refers more to the spread of the injury than to its location. Under this classification, TBI is considered either focal or diffuse. As the name implies, focal injuries affect a particular part of the brain. Most primary injuries are also focal injuries.
Diffuse TBI, on the other hand, may cover a larger area in varying degrees of severity. They are more commonly caused by internal damage, often the same factors that create secondary TBI. Examples include whiplash, vascular injury, and meningitis. Focal and diffuse TBI often occur together, with the latter manifesting at a later time.
Classifications by severity
TBI can also be classified as mild, moderate, or severe. This classification is mainly used to identify treatment options and provide a prognosis. It is usually determined by neurological function (measured according to the Glasgow Coma Scale or GCS) and the duration of unconsciousness.
The GCS measures consciousness according to eye-opening, motor, and verbal responses, on a scale of 3 to 15. TBI is considered mild when the reading is from 13 to 15 and the loss of consciousness (LOC) lasts 30 minutes or less. Moderate TBI means a GCS level of 9-12 and LOC lasting no more than six hours. Severe TBI is defined as a GCS reading of 8 or less, and more than six hours of LOC.
This article is not intended as legal advice.
Additional information available from the Law Offices of Elan Wurtzel, P.C.. Serving clients in Plainview, New York