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How a Shearing Injury Occurs

The brain works by transmitting signals along nerve bundles called axons. Axons look something like bundles of electrical cables packed close together. The axons are wrapped in a protective fatty sheath which acts as a cushion and helps transmit brain signals.

Axons can be jolted and disrupted without much damage if the impact is small. The dizziness and confusion you feel after hitting your head is the axons resetting themselves. The heavier the impact, the more the axons are shaken, and the worse the injury can become.

In the worst cases, the axons can become torn or severed, cutting off the section of the brain. This type of damage is called a shearing injury, or axonal shearing, and results in serious brain damage.

What Causes Axonal Shearing?

Axonal shearing happens when the brain is subjected to impacts from multiple directions. The human brain does not fill the entire skull. There is room for the brain to move back and forth slightly. In a serious impact, like a car accident, the brain can move so far that the axons are stretched and torn. 

This severs the axon and prevents messages from being sent along the axon to the next brain cell. Just like your computer can’t access the Internet if the power cable is cut, brain cells can’t access each other if the axons are severed.

If too many axons are damaged, the section of the brain loses its ability to communicate with the rest of the brain. This is called a diffuse axonal injury, or DAI. Depending on which section of the brain is cut off, symptoms of this injury can include:

• Headache
• Nausea and vomiting
• Confusion or disorientation
• Dizziness and loss of balance
• Unconsciousness
• Coma
• Death

DAI is a very serious injury with life-altering consequences. Research indicates that the brain tissue does not heal itself following a shearing injury. The brain can learn to use undamaged portions of the brain to carry out the same functions as the damaged area, essentially rerouting the brain. This can take two to three years in a younger patient. As brains get older, they lose this ability to reroute as easily.

How Accidents Cause Shearing Injuries

The brain is well-protected inside the skull. It is surrounded by a network of blood vessels and connective tissue called dura that cushion it like an egg surrounded by a water balloon. If the skull is shaken too hard, as in a car accident or other impact, the dura is not sufficient protection.

Coup-contrecoup injury. When the brain hits one side of the skull, it produces axonal shearing or bruising. This is called a coupe (French for “blow” or “strike”) injury. The brain will bounce back from the interior of the skull, and if the first strike was hard enough, recoil into the opposite side of the skull, a contre-coup (“reverse blow”) injury. 

These back-and-forth forces are responsible for the axonal shearing that leads to a DAI. Coupe injuries are associated with an object hitting the head, like a baseball. Contre-coup injuries are associated with the head hitting an object, like a dashboard. However, the powerful shaking forces of a car accident can cause a coup-contrecoup injury even without something hitting the head. These injuries are also seen in bad falls, and in shaken baby syndrome.

“Second impact syndrome” refers to the effect of multiple head injuries. It is now known that the effects of traumatic brain injuries are cumulative. It used to be thought that a “mild concussion” was no cause for concern. A single impact may not cause a shearing brain injury or DAI, but multiple shearing brain injuries lead to more axons being damaged and a greater loss of brain tissue. Anyone who has suffered more than one head injury, especially within the last year, is at increased risk for DAI later.

Claims for a Shearing Injury Case

The outlook for someone with a serious shearing injury is bleak. The torn axons will not heal, and the damaged area of the brain is essentially dead. The effects of a DAI resemble a serious stroke. Unless the damage is minor, the patient faces a lengthy recovery and rehabilitation. Some of these effects include: 

• Cognitive deficits, ranging from chronic headaches, memory difficulties, inability to speak or understand speech, hearing loss, vision problems, loss of concentration and ability to focus.
• Motor deficits can include paralysis, tremors, changes in gait, weakness, inability to perform daily life activities (such as brushing teeth or combing hair), loss of balance.
• Psychological changes are common, both from the damage and from the loss of function and may include anxiety, depression, apathy, irritability, loss of social skills, and loss of inhibitions.
• Long-term deficits like epilepsy and other organic brain disorders are possible.

You should be able to recover compensation for your injuries if they are caused by another person’s negligence.

In serious cases, patients may require supportive care for the remainder of their lives. In seemingly minor cases, the damage may not appear for months or years. In the worst cases, the patient may be left in a vegetative state, and require life support unless or until they recover.

You may be able to recover medical costs, loss of income (or the income of your loved one), and the costs of future care for the condition. You are also allowed to claim non-economic damages, such as pain and suffering and loss of consortium. Because a person with a DAI is unlikely to recover fully, you may have a claim for the remainder of their life.

Our Experienced Traumatic Brain Injury Attorneys Can Help

If you or a loved one have been involved in an accident and suffered any type of head trauma, the first thing you should do is seek medical attention. Although not all injuries are readily observable by CT or MRI scan, you should have an examination.

If your accident was due to the carelessness or negligence of another person, or the result of unsafe work practices, you should consult a legal professional right away. The long-term medical consequences of DAI injuries are serious, and you and your family should not have to pay for another person’s thoughtless behavior.

Contact the legal team of D’Amore Personal Injury Law at 410-324-2000, or fill out our intake form online. We are here to help you get the compensation you need for your injuries and care.