How Does the Brain Get Injured?
Lawyers who deal with brain injury claims have to be familiar with the different ways that the brain can be injured.
Open head injury vs Closed head injury
Obviously your brain can be injured by direct impact, both to your skull and through your skull to your brain. The distinction between a broken skull (referred to as an “open head injury”) and a non-broken skull impact (referred to as a “closed head injury”) is a lot less important than it sounds. Recent research suggests that closed-head injuries, where the skull remains intact, can result in severe brain injuries similar to open-head injuries.
Skull fractures can prevent brain injury
The reason is that sometimes skull fractures may actually prevent further injuries to the brain. In closed head injuries the pressure from the swelling brain can build up and, without release, cause further damage to brain tissues. Skull fractures can provide a release from the pressure and prevent extensive brain injuries.
So in some cases, doctors may perform surgery to intentionally open the skull (called a “craniotomy”) in order to release pressure on the brain. The bone that is removed from the skull is then replaced at a later date once the brain swelling has gone down.
Don’t need to hit your head
One of the major myths of brain injuries is that you need to hit your head against something, or have something hit your head, for them to occur. You can read this article to learn more about the 8 Myths of Traumatic Brain Injury
Sponge in a bucket
Your brain is not strictly fastened to your skulls. Instead, it is loosely suspended in fluid. Imagine your brain as a sponge floating in water (cerebrospinal fluid) in a bucket (your skull).
One way for that sponge to be impacted would be for you to smash a hammer into the bucket with enough force that the sponge suffers some of the impact. Another way for that sponge to be impacted would be if the bucket was moving in one direction, (like if you were swinging the bucket while you walked), and then for it to suddenly stop.
The sponge would almost definitely bump against the inside of the bucket. Similarly our brains can bump against the inside of our skulls, resulting in brain injuries without external impact.
The other way your brain can be injured without actually hitting your head is if something happens to reduce or cut off the flow of blood or oxygen to your brain. Your blood carries oxygen and glucose need for cell metabolism. So anything that reduces or cuts off the flow of blood to your brain can result in a brain injury, even if you don’t hit your head.
Ischemia is a medical term for reduced blood flow. When the flow of blood to your brain is reduced over a long period of time, this is called chronic ischemia. When your blood flow is cut of suddenly it is called acute ischemia.
The most common cause of brain injury caused by ischemia is a strokes. Strokes are a medical emergency, but the long term effects of a stroke can be reduced or eliminated if the patient receives rapid and timely treatment.
Hypoxia is the medical term that refers to what happens when part of the body is deprived of oxygen, usually because of reduced blood flow. When the suppy of oxygen is totally cut off, it is referred to as anoxia.
Birth trauma may cause brain injury
Hypoxia and ischemia during labour and delivery are known to be two of the causes of traumatic brain injury in children, specifically cerebral palsy. See for example our article Cerebral Palsy Claims: The link between medical malpractice and CP
Not every child that suffers hypoxia and/or ischemia during delivery will suffer a brain injury. To learn more about the issue you can read our article: Birth Injuries Caused by Oxygen Deprivation: Hypoxic Ischemic Encephalopathy