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Diffuse Axonal Injuries and Their Ramifications in Injury Cases

Updated February 20, 2021 | By Wilson Kehoe Winingham staff

Most attorneys are familiar with the general effects of events like whiplash on a client’s back and neck. But there may be other effects of a whiplash occurrence, such as rotational injury and the head impacting with an object, which can result in temporary or permanent brain damage.

Although often associated with Shaken Baby Syndrome, Diffuse Axonal Injury (DAI) is a growing area of plaintiff’s personal injury law, especially in low impact cases like whiplash following an automobile accident.

What are Diffuse Axonal Injuries?

DAI occurs when the white matter of the brain is suddenly and violently shaken, twisted, or torqued in some way. Injury occurs because the unmoving brain lags behind the movement of the skull, causing brain structures to tear at a microscopic level.

Axons are long fibers that are a part of neurons in the brain. An axon extends from a cell body and communicates with other cells through electrical impulses. When DAI occurs, axon fibers are torn up and the communication process is disrupted, oftentimes resulting in injuries to many parts of the brain, thus diffusing the injury.

DAI happens when the skull moves violently while the stationary brain stays in place, causing diffuse and sometimes extensive tearing of nerve tissue throughout the brain. It can also cause brain chemicals to be released, causing additional injury and axonal death radiating outward from the tear. This disturbance in the brain can produce temporary or permanent widespread brain damage, coma, or death.

Consequences of DAI

The actual consequences of DAI—even those resulting in mild or moderate alteration of brain function injury—can be as catastrophic and disabling as any other type of brain injury. Of the patients who have DAI, an estimated 25% will result in death. It is one of the most severe forms of traumatic brain injury that can occur.

A person with this injury can experience a plethora of functional impairments, depending on what parts of the brain were torn in the accident. When DAI first occurs, the person may experience a loss of consciousness. If the person remains conscious, they will have telltale signs of other symptoms of brain damage.

Usually, the person will have behavior changes causing irritation or agitation as a hallmark sign, and higher cognitive functions such as memory, communication, understanding, and emotion can be affected. Immediate to lasting side effects may include headaches, nausea, fatigue, trouble sleeping or sleeping longer than usual, and dizziness. If these symptoms sound familiar to you after a car accident, go to a hospital and contact an experienced personal injury lawyer.

DAI Lawsuits

Most troubling for attorneys is the fact that many of these DAI injuries are not accompanied by a loss of consciousness, skull fracture, or intracranial bleeding, thus the difficulty of proof at trial.

Research seems to indicate that DAI actually occurs in two phases:

  1. the stretching and tearing of the axons on impact and;
  2. biochemical changes at the cellular level that may result in edema or swelling that occurs at a later time, perhaps as long as several weeks later.

One of the more difficult aspects of a DAI case is that the damage occurs to nerves that are so subtle that the extent of the damage frequently doesn’t show up on traditional imaging such as X-Rays, CT scans, or MRI scans, leaving proof of DAI in the hands of medical experts and in the hands of personal injury attorneys who have experience in this area.

Newer imaging studies, while controversial, are gradually being accepted as evidence to demonstrate the presence of DAI. These include SPECT scans, PET scans, Proton Magnetic Resolution Spectroscopic Imaging, and Tensor Magnetic Resonance.

Contact a Brain Injury Attorney Today

If you or a loved one have suffered a brain injury as a result of negligence, you are urged to contact the Indianapolis Brain Injury Attorneys of Wilson Kehoe Winingham. The lawyers at WKW can help you get the compensation you deserve. Call 317.920.6400 or fill out an online contact form for a free, no-obligation case evaluation.

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