What is a "Diffuse Axonal" Traumatic Brain Injury?

This is an extremely common type of brain injury we find in our Traumatic Brain Injury law practice. The diagnosis or term simply means that brain damage occurs over  a more widespread area than in a specific, or "focal," traumatic brain injury. Diffuse Axonal Brain Injury is more commonly referred to as "DAI" for "Diffuse Axonal Injury." Thus, it is injury to the brain's axonal tissue and unlike brain injury or trauma due to a direct force or impact, or due to deformation of the brain itself, DAI is the result of a traumatic shearing force that occurs when the human head is rapidly accelerated or decelerated, as may occur in auto, motorcycle, or truck accidents, slip or trip and falls, sports injuries, or assaults. More commonly the axonal brain tissue is injured or damaged from rotational forces or from what is called a "severe deceleration." However, my San Diego injury law practice sees these types of brain injuries most frequently from vehicle accidents; however, it can also occur from child abuse such as the widely publicized "shaken baby syndrome."

The majority of damage in DAI cases in the disruption of axons (conducts electrical impluses away from a neuron, or nerve cell) which communicate neural impulses to one nerve cell to another in the brain. Shearing forces of the axonal tissue refers tissue damage when tissue slides over other brain tissue (axonal tissue). These forces stretch the axonal tissue over different areas of density.

Types of Injuries as the Result of Diffuse Axonal (DAI) Injury to the Brain:

Unfortunately, the most severe type of DAI to the brain is coma - in fact, over 90% of patients or severe car accident victims with serious DAI to the brain never regain consciousness slipping into a permanent coma. Those that do wake up from this type of coma are extremely lucky - however, sadly they often awaken with significant impairment to their brain. Most doctors now agree that there is a wide range of injuries that can come to pass with a DAI type injury. This ranges from coma to mild concussion type injuries. Of course, concussion type injuries are rated as a much milder type of diffuse axonal injury to the brain.

Diagnosing and Treatment of DAI to the Brain:

DAI can be very difficult to detect (depending on severity of course), and this is due largely to the fact that it does not show up well on CT scans or other macroscopic  imaging techniques. However, it shows up nicely on the microscopic level and that is what a good California Brain Injury lawyer has to depend on in order to prove DAI in a California court of law. At the San Diego California Law Offices of Mark C. Blane, we have helped victims of car accidents who have DAI prove their case to the at-fault insurance company(s). Employing new diagnostic techniques like Diffusion Tensor Imaging, and PET scans a good brain injury lawyer can now effectively communicate the damage an injury. Also calling family and friends as lay witnesses at trial can help communicate the damage - meaning these witnesses can help explain how a DAI victim was (personality wise) before the DAI producing accident. Many times brain injury lawyers rely on this type of testimony to "fill in the blanks" on this type of brain dysfunction.

In terms of treatment, depending on the severity of DAI to the injured person, there are brain membrane sealants called Polyethylene glycol that can serve to prevent further damage to the axonal tissue. Time and blood flow are also other factors that can influence healing time - remember, the injury causes stagnation of blood flow due to the injured area now being injured and the tissue that was damaged is not the same. Research is still on-going and only further time will show what is working for these type of hidden injuries.