Types of Traumatic Brain Injuries

By Peter DePaolis

MRI brain imagesTraumatic brain injuries can result from either a closed head injury or a penetrating head injury. A closed head injury occurs when an object suddenly hits the head but does not break through the skull. A penetrating head injury, on the other hand, results from an object piercing through the skull and entering the brain tissue. Brain injuries resulting from either instance can be focal brain injuries, where only one area of the brain is damaged, or they can be diffuse brain injuries, where multiple areas of the brain are damaged.

If you have been injured in an accident that was due to the negligence of another, the accident may have long-lasting effects on your life and the lives of those around you. It is important that you contact a Northern Virginia brain injury lawyer who can assist you in assessing the nature and extent of your injuries, as well as help you obtain compensation from the responsible party.

Types of Traumatic Brain Injury (TBI) and Head Trauma

Your brain controls every part of your body, so you may experience different TBI symptoms depending on which area of your brain is injured and how that injury occurred.

There are a number of more specific types of traumatic brain injuries, including:

  • Penetrating Brain Injuries
  • Concussions
  • Contusions (bleeding of the brain tissue)
  • Diffuse Anoxal Brain Injuries
  • Recurrent Traumatic Brain Injuries(Second Impact Syndrome)
  • Coup-Contre Coup Injuries
  • Shaken Baby Syndrome
  • Locked-In Syndrome
  • Hypoxia and Anoxia

Penetrating Traumatic Brain Injuries

As mentioned above, penetrating brain injuries are those that result from an object actually piercing through the skull and entering the brain tissue. Oftentimes, such an injury results from the impact of a bullet, knife or other sharp object. Objects traveling at lower rates of speed through the skull can actually cause more damage because the object may ricochet within the skull, increasing the area of the brain affected by the injury. Another injury that can cause extensive damage is referred to as a “through-and-through” injury, where an object enters and exits the skull. This injury may cause additional stretching and even rupturing of brain tissue. The most fatal form of a penetrating brain injury is bullet wounds, which have a ninety-one percent death rate.


Concussions are the most common type of traumatic brain injury. A concussion, also known as a mild traumatic brain injury, can be caused by direct blows to the head, gunshot wounds to the body or sudden changes in momentum, such as from whiplash or forceful shaking of the head. Often, a person loses consciousness for a brief period of time, but this is not always the case. Concussions are usually found by using diagnostic imaging tests, such as CAT scans or MRI scans.

A mild traumatic brain injury like a concussion typically takes anywhere from a few months to a few years to heal. Concussions occasionally cause other more serious conditions, such as a blood clot in the brain or a diffuse axonal injury. For this reason, it is important to closely monitor an individual who has suffered from a concussion to ensure that they heal completely.


A contusion is a bruise on the brain that results from a direct impact to the head. A large contusion can cause swelling and bleeding of the brain, which can result in more serious and sometimes deadly complications. Contusions often heal on their own, but a large contusion may require removal via brain surgery.


A coup-countrecoup injury is a type of injury where there are two contusions – one that is located both at the site of the impact and one located on the opposite side of the brain. This type of injury results from a force so strong that it forces the brain to slam into the opposite side of the skull, causing an additional injury.

Diffuse Axonal Brain Injury

A diffuse axonal brain injury is caused by shaking or rotating the head. When the head is moved quickly and forcefully, the brain can move slower than the skull resulting in torn nerve tissue throughout the brain. This can result in damage to different sections of the brain, as well as the release of brain chemicals. The long-term effects of a diffuse axonal brain injury can include widespread brain damage, impairment of motor function, a coma, and sometimes even death.

Shaken Baby Syndrome

Shaken baby syndrome is a particular form of diffuse axonal brain injury that occurs when someone aggressively shakes a baby or young child. Shaking the child in such a forceful manner causes blood vessels between the brain and skull to rupture and bleed, which results in the compression of brain tissue. Because the child’s brain is still young, this can lead to damaged brain cells that may affect the child’s overall development.

Symptoms of shaken baby syndrome include seizures, irritability, changes in eating patterns, difficulty breathing, fatigue, dilated pupils, and vomiting. The long-term effects of shaken baby syndrome may include disability, seizures, comas and death.

Recurrent Traumatic Brain Injuries

Recurrent traumatic brain injury (also referred to as “second impact syndrome”) occurs when a person suffers from a second traumatic brain injury before the first injury has completely healed. Because of the danger of having two brain injuries at the same time, the second injury is likely to cause brain swelling and widespread damage throughout the brain.

Second impact syndrome can occur even after a mild traumatic brain injury like a concussion. Athletes are particularly at risk for multiple concussions, which can cause extensive injury especially if they go undiagnosed. The long-term damage resulting from a recurrent TBI includes muscle spasms, mood swings, hallucinations, difficulty concentrating and depression. In the most extreme cases, chronic traumatic encephalopathy (CTE) and dementia can result.

Locked-In Syndrome

Locked-in syndrome is a neurological condition where a person is conscious and able to think, but completely unable to move any part of the body except the eyes. This condition is caused by damage to portions of the lower brain and brainstem, but without injury to the upper brain.

Locked-in syndrome is also caused by stroke, brain hemorrhage, medication overdose, damage to nerve cells and disease of the circulatory system, in addition to TBI. There is no cure for locked-in syndrome and victims of this condition rarely regain motor function. If this condition occurs, blinking and other eye movements can be used to communicate with others.

Contact a Northern Virginia Brain Injury Attorney Today!

If you have suffered from a traumatic brain injury, it is important that you consult a physician to determine the nature and extent of the injury. Once you have learned about your injury, it is important that you determine the cause of your injury. If you think your injury may be due to the negligence of another, contact us to speak with a Northern Virginia personal injury lawyer at Koonz, McKenney, Johnson & DePaolis L.L.P., to assist you in recovering compensation for your injury.

About the Author
Peter DePaolis joined the firm in 1980 and has since represented a large number of individuals involved in automobile collisions, truck accidents, bus crashes, defective products, and medical malpractice cases. A significant portion of Mr. DePaolis’ practice is devoted to working on behalf of people suffering from asbestosis, mesothelioma, and other asbestos-related cancers. He has led his firm’s fight against the asbestos industry and has recovered over $30 million in damages for asbestos victims and their families.