The Medicine

“DAI” or diffuse axonal injury is the physical tearing or sheering of the white matter tracts deep within the brain. It is caused by any sudden deceleration or torsional movement. It does not require an impact to the head, a violent whiplash is a sufficient mechanism of injury to trigger it. It is therefore not surprising that so much DAI is caused by road traffic accidents.

Initially following DAI there will be a finite period where the brain is unable to lay down clear and continuous memory. This period is known as Post Traumatic Amnesia (“PTA”) and it’s length determines the severity of the initial cerebral insult. The inability to lay down continuous memories is the reason why the injured person may not have a full memory of events immediately after the trauma.

There is a poor correlation (0.3) between severity of injury according to PTA and outcome. In other words some people make a good recovery from a ‘severe’ traumatic brain injury and some make a poor recovery from a ‘mild’ head injury. In the more serious cases of traumatic brain injury the person may be rendered unconscious but unconsciousness is not necessary for DAI to occur.

Cognitive and behavioural symptoms usually develop quite quickly. The classic symptoms that often develop are set out here.

The development of one or more anxiety disorders is common following traumatic brain injury. PTSD and OCD occur frequently following head injury as does a reactive depression once the injured person realises that they are no longer the same.

Dickinson Solicitors believe that psychological treatment for any presenting anxiety conditions is essential, not just as part of the rehabilitation process but also to undermine the common defence that all the cognitive and behavioural symptoms are due to psychological factors not brain injury.

Psychological injuries can usually be successfully treated. Organic brain injury cannot and symptoms that remain 2 years post injury are likely to be permanent. This is why attribution is so important.