The brain controls all the functions of the human body. It is soft organ which floats in fluid called cerebrospinal fluid, inside the skull, which encloses it. There are also a number of layers of protective covering over the brain, called the meninges. For the most part, there is no place for the brain to swell inside the skull.

The cerebral cortex, the upper part of the brain, has two halves, each divided into lobes. The frontal lobes, just under the forehead, and the temporal lobes near the ears are the most susceptible to injury because of their position. In very general terms, the frontal lobes control a lot of motor functions, but also judgment, emotions, motivation and memory. The temporal lobes are involved with hearing, and contain areas needed to formulate and comprehend language. There are also two parietal lobes, which are needed to understand sensory input, and two occipital lobes in the back, containing visual areas. The cerebrum is part of the forebrain, where “higher” level functions are processed, like thinking and problem solving. The cerebellum, which has a large role in control of movement, is just under the cerebrum in the back. The brainstem includes the midbrain, the pons and medulla oblongata, which help control respiration and heart rhythms, and other areas which receive sensory input from the body and transmit it to various parts of the brain.

The brain is made up of nerve cells, called neurons. They each have axons, which are the parts of the nerve cells that communicate with other nerve cells. So, imagine this soft organ inside the skull. A blow to the head will cause trauma. It is called closed trauma if the skull is not broken, and open trauma if the skull is broken or breached, by, for example, a bullet.

Many cases of TBI involve closed trauma. Again, imagine the head striking the pavement. Even though there is a little cushioning, the closest area of the brain will hit the inside of the skull. The force of the fall will be transmitted to the brain. There might be a bruising of the brain. The most common parts of the cerebrum to bruise are the temporal lobes and frontal lobes, and brainstem. Imagine a bruise on an arm or leg. As time goes on, the bruise will swell. In the case of the brain, there is no room for the swelling, causing further problems.

If the head is whipped back and forth with the blow or even without a blow, for example if a passenger rear-ended in a car accident and and his head is falls forward and then is snapped back as the car stops, the brain can actually ricochet from one side of the skull inside to the other, and become damaged 180 degrees opposite the original blow. This is from acceleration and deceleration forces. The damage is called a coup and then a contrecoup blow. There are now two bruises.

There can also be bleeding when the brain is injured. If a blood vessel is torn as the brain moves back and forth inside the skull, there will be bleeding, and a blood clot, or hematoma, will form. If the blood vessel was torn under one of the protective layers around the brain, a subdural hematoma will form. If an arterial vessel is torn between the skull and the protective layer, an epidural hematoma will form. There can also be bleeding inside the brain tissue itself, called an intracerebral hemorrhage or hematoma. All of this increases the pressure inside the skull.

As the brain swells, or hematomas form, the pressure goes up inside the skull. The only opening out is through the bottom of the skull, where the spinal cord and some nerves leave the brain. It is a very small opening, and if the brain swells enough, the brainstem, which is lowest down, will be forced into that small opening. That is called herniation. Since that part of the brain controls respiration and heart rhythms, herniation can cause death.

These are all big injuries which can be seen on CT scan. However, there is also damage occurring with a blow to the head on a cellular level. The body of the brain cells can get disconnected from their axons as the tissue stretches. This may cause damage to or death of the cell, which is never just one cell, but many. The damage is called diffuse axonal injury. It can prevent the parts of the brain from communicating with each other. Diffuse axonal injury cannot be seen on diagnostic studies such as CAT scans.

The damage described is what happens with the first injury to the brain, when the fall or blow actually impacts the head. These are the injuries that people start out with, called primary brain injuries. As time goes on, and especially without treatment, there can be secondary brain injuries, which are further injuries that occur because of the initial damage to the brain and in many cases, such as car accidents, to the body.

An example of the secondary injury is brain swelling, or edema, which can prevent enough blood and oxygen from getting to the rest of the brain. Sometimes removing a clot will stop that process, and there are other treatments to try and lower the pressure inside the skull so that blood can get to the rest of the brain.

Another example is when there is not enough oxygen getting to the brain. This can happen when someone is severely injured and their blood pressure is low, or their breathing is impaired, and enough oxygen in the blood is not getting to the brain. Doctors have to do all they can to treat all the injuries to prevent this, which is called hypoxia.

When doctors first assess and treat an injured patient, there may be more life-threatening injuries to deal with than the head injury. As they deal with these other injuries they are making sure the patient’s blood pressure stays up, and that the heart and lungs are working. That helps the brain. With the scanning and means of intervention available today, there is much less secondary brain injury.

Brain Injury Compensation Claim Solicitors

We are qualified lawyers specialising in compensation claims for personal injury resulting from UK accidents caused by the negligence of a third party. We deal with physical injuries of the utmost severity including catastrophic damage to the spinal cord and brain and consequential psychological damage. If you would like to speak to a brain injury compensation claims solicitor without any obligation whatsoever just use the contact form or call the helpline. Our advice is free and if you decide to use our services we operate a totally risk free no win no fee scheme. Compensation is paid in full with no deductions and win or lose there is no charge.

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