Diffuse Axonal Brain Injuries

A Diffuse Axonal brain injury is one of the most common but often devastating forms of head injury. It is diagnosed in almost half of head injury cases categorised as severe and will often result in loss of consciousness and a coma.  It can cause swelling of the brain and increased pressure, which if not stabilised can have fatal consequences.

 

Diffuse Axonal Injury, commonly abbreviated to DAI, is a recently recognised condition, the term coming into use in the early 1980’s. Recent medical advancements have led to improved early diagnosis and treatment but tragically, approximately 90% of patients with a severe Diffuse Axonal Injury still do not regain consciousness.

This type of brain injury was ultimately fatal in the case of the Formula 1 driver Jules Bianchi who died on July 17 2015 following a brave struggle to recover from the traumatic head injury he sustained in the Japanese Grand Prix in October 2014.  Bianchi had been in a coma since his tragic accident.

What are the causes of a diffuse axonal brain injury?

A Diffuse Axonal Injury is caused by the sudden movement of the brain within the skull. It is categorised as a closed head injury because the skull itself is not penetrated, in contrast to an open head injury where the skull is fractured.

Statistically, the most frequent cause of a Diffuse Axonal Injury is road traffic accidents when the sudden deceleration caused by a collision forces the brain to jolt rapidly forward and then back again, effectively rattling around inside the head.  The brain is essentially soft tissue floating in fluid inside the skull and consequently it is delicate and vulnerable.  This rattling effect causes the disruption to the axons - the wires in the brain that carry signals.

Other well-known causes of Diffuse Axonal Injury include falling accidents, sports related injuries, violent acts and Shaken Baby Syndrome.

Recognising Diffuse Axonal brain injury

Diffuse Axonal Injury is recognised to be very difficult to diagnose. The generalised nature of the injury and the microscopic level at which the injury happens means that it will not always be apparent under conventional brain scanning. As a result, the injury is often more severe than first appreciated.  

There is however a range of severity and at the mild end of the spectrum will be patients who have suffered short-term concussion who go on to make a full recovery. Top Gear presenter, Richard Hammond, also sustained a Diffuse Axonal Brain Injury but has gone on to make a good recovery.

Diffuse Axonal Injury is an injury occurring when the fibres, known as axons, which connect cells in the brain, are disrupted or, in the worst cases, torn. This disruption means that there is a breakdown in the signals in the brain, which can affect the most basic of human function.  

The other distinguishing feature of a Diffuse Axonal injury is that, unlike many other brain injuries, the area of the brain affected is more widespread (diffuse).

What are the symptoms?

The most common and obvious symptom of Diffuse Axonal Injury is loss of consciousness, even if temporary, and in more severe cases it can lead to the patient falling into a coma. In less severe cases, consciousness may not be lost and the symptoms can be more subtle.  These symptoms will be very similar to those of other traumatic brain injuries such as headaches and dizziness.  The type of symptoms will depend on the severity of the injury and the parts of the brain that have been affected. 

Diagnosing a Diffuse Axonal Injury when consciousness is not lost requires a close examination by the clinician by questioning the patient on the events that caused the head injury and identifying signs that brain function has been damaged.  Subtle changes in the ability to move limbs, in short term memory or in the capacity to speak may be indicative.  As with all head injuries, the symptoms can become apparent over time and unless they are identified in good time and treated they may not fully resolve. 

Treatment and rehabilitation

As with all brain injuries, the implementation of early and appropriate treatment will result in the best outcomes. In cases of severe Diffuse Axonal Injury a full recovery is unlikely because is not possible to surgically re-attach disconnected axons. In these cases, the focus is on returning the patient to best possible level of function through implementing a multi-disciplinary programme of rehabilitation. This will include physiotherapy, occupational therapy, psychological therapy and speech therapy. Counselling and the introduction of adaptive aids and equipment may also form part of the rehabilitation programme.

If you or a loved one has sustained a diffuse axonal brain injury or other form of brain injury, you could be entitled to compensation. We are brain injury specialists with considerable experience in pursuing these complex cases to ensure our clients receive the maximum amount of compensation possible for their life-changing injuries. For professional and sensitive advice on making a claim for the injury and the subsequent medical care, rehabilitation and home modifications required, please contact our specialist brain injury solicitors on 0333 123 9099. Alternatively, you can send an email with your name and contact information and brief details as to the nature of the incident and the injuries sustained to enquiries@ibbclaims.co.uk or complete our online form.