Brain Injuries

man holding head

What You May Not Know About Head Trauma

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Head trauma and brain injuries are surrounded by a wealth of myths and, unfortunately, many people may not know as much as they should about this potentially serious injury. Let us shed some clarity on this topic and debunk some of these untruths.

A commonly held belief is that younger individuals have an easier time recovering from a head injury, thinking that somehow youth is equivalent to strength. You are actually more vulnerable when young, however, since a young brain may not be fully developed and will thus have a difficult time developing in the future due to the damage inflicted on it.

It is also often thought that traumatic brain injuries are not that common and mostly afflict football players or veterans. Head trauma is actually quite widespread and usually occurs as a result of a fall or automobile accident. According to the Neurologic Rehabilitation Institute at Brookhaven Hospital, over 1.7 million people experience brain injuries every year, making it an undeniably major health problem.

Among the varying kinds of head trauma that exist, concussions are the most common. What you may not know is that you do not have to black out in order to have a concussion, nor do you need to exhibit lasting symptoms. A concussion can actually occur any time an individual receives a blow to the head that causes symptoms to show, either for a short amount of time or a prolonged period – length of time in symptoms only help in determining the severity of the concussion. Some of these symptoms include trouble sleeping, seeing stars, difficulty concentrating, balance problems, and difficulty with memory.

Although most people are able to fully recover from a concussion, people often think it means that this type of head trauma is inherently mild with no lasting damage. Unfortunately, complications may occur if an individual suffering from a concussion does not seek treatment or if they continue to engage in the activity that lead to the concussion – something often seen in athletes of all levels.

Vanguard Attorneys are experts in this area and have the compassion and skill to represent you or your loved one if you have suffered a traumatic brain injury as a result of someone’s actions, whether it was intentional or accidental. Call us at 813-737-7361 for a free consultation.

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National Brain Injury Awareness Month

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According to the Brain Injury Association of America, March has been designated as National Brain Injury Awareness Month, to promote discussion of traumatic brain injuries. Each year, around 2.4 million children and adults in the Unites States suffer a traumatic brain injury, with two percent of the entire population still suffering from remnant issues from an injury already experienced. In addition to the staggering high number of TBI victims, 795,000 Americans sustain an acquired brain injury (ABI) every year from causes other than trauma.

Suffering from traumatic brain injury can affect a victim’s life in a multitude of ways from a short-sustained catatonic state to a complete loss of motor functions or paralysis. To this day, researchers do not fully comprehend the process the brain undergoes after a head injury, or just how long particular, latent effects can last. But the lost of brain function that leads to inability to succinctly think, reason, or remember moments of the past, undoubtedly provides great stress and strain for victims all around the world. So this month, March, will forever be labeled as National Brain Injury Awareness Month, and hopefully, in time, with the right amount of effort put into understanding this treacherous malady, we can diminish the stranglehold it has on our society.

Source: Brain Injury Association of America

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Community of Spoto Rallies Behind Girl Who Suffered Traumatic Brain Injury

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When the people of Spoto found out about the unforeseen car accident on Lee Roy Selmon Expressway that left Tyra Janelle Brown, 18, fighting for her life, they came together for the cause. Brown suffered a traumatic brain injury that left her in a catatonic state, as her parked car, according to Florida Highway Patrol, was struck by another vehicle. She rode with Makayla Anne Harrell and Brittany O. Jackson early on January 11, when the car needed to be curbed due to a flat tire. As they waited for AAA, alongside the interstate, a driver lost control of his car and hit the girls. Although all three of the girls were injured in the accident, only Tyra Brown’s injuries were life threatening.

By word of mouth of Brown’s harrowing condition, three-quarters of the 1,400 students that make up Spoto High School gathered around the school’s flagpole on a solemn Monday morning last month in her honor. After the short ceremonial pause, the students made their way back to class.

“Not one student was late to class,” said Spoto math teacher Wendy Smith, fighting back tears. “I’ve never seen anything like it and I’ve taught since 1980.”

“Tyra is a wonderful, wonderful student,” said Smith, who has taught Brown for three years and spoke on behalf of her family. “She’s a wonderful girl, a wonderful role model. She’s just great. The kids all like her.”

Through her rather prolific high school career, Brown captained the cheerleading squad, served in student government, and became a member of the National Honor Society. In her sparse free time, she even visited with some of the students affected by autism, at times dancing with them. By the time of her accident, she had gained admission to the University of South Florida and University of Central Florida, planning to eventually become a pediatric nurse.

The incident has undoubtedly affected the school, but most importantly, it has brought strain to her family. Her single mother, Cynthia Leeks, Frost Elementary School teacher, has already used all her sick days sitting at her daughter’s bed. Teachers at Spoto and Frost are trying to give their sick days to Cynthia. Now, Tyra has been moved to Atlanta’s Shepherd Center, a hospital that specializes in spinal cord and brain injuries. Unfortunately, the hospital can only provide Cynthia an apartment for thirty days. So, in accordance to the altruistic nature at Spoto High School, the students have organized spirit nights at local restaurants and a 5k run to raise money.

“They don’t know what to do but they want to do something, anything,” Smith said. “They’re special kids. They don’t understand why this has happened.”

Source: Tampa Bay Times

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Anoxic Brain Injury – Causes, Symptoms, Prognosis

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An anoxic brain injury occurs when brain cells are damaged due to a total lack of oxygen. Doctors also refer to the condition as anoxia. Brain cells are effected almost immediately without oxygen and begin dying off permanently after only four minutes of oxygen deprivation. Each additional passing second results in cumulative brain cell death. Anoxic brain injuries are a common childbirth injury, but also results from drowning or from cases of asphyxiation or strangulation.

Doctors sometimes associate anoxic brain injuries with hypoxic brain injuries or hypoxia. However, the two classifications refer to different events. While an anoxic brain injury results from a complete lack of oxygen to the brain, a hypoxic brain injury results from a reduced supply of oxygen to the brain. Hypoxic injury is more commonly associated with chronic illnesses or environmental conditions, such as low oxygen saturation at high altitudes. Anoxic injury is more typically associated with cases of complete asphyxiation.

Causes of Anoxic Brain Injury

Anoxic brain injuries can be caused by a few different environmental conditions, diseases, disorders or accidents such as:

  • Brain Tumors
  • Cardiac / Respiratory Arrest
  • Childbirth (strangulation)
  • Asphyxiation from entrapment or suicide attempt
  • Drowning
  • Drug Use (Inhalants / Opioids)
  • Suffocation
  • Electrocution
  • Malfunctioning Gas Appliances in the Home (Carbon Monoxide)
  • Poisoning

Symptoms of Anoxic Brain Injury

In addition to childbirth injuries, an anoxic brain injury may follow a long period of unconsciousness. A comatose patient may enter a vegetative state as a result of a serious anoxic injury. After any patient has been in comatose for any length of time, doctors will monitor a patient waking from a coma for signs of brain injury such as:

  • Confusion/inability to concentrate
  • Impaired balance/coordination
  • Headache
  • Mood swings/irritability/depression
  • Sleep disruptions/loss of consciousness/fainting spells
  • Seizures

Anoxic Brain Injury Prognosis

After an accident involving asphyxiation or as a coma patient awakens, a neurologist may order one or more of the following tests if he/she suspects an anoxic injury:

  • CT s- a test that scans the head
  • Electroencephalogram (EEG)—a test that measures the amount of electrical activity in the brain
  • Evoked potential tests—tests used to evaluate the visual, auditory, and sensory pathways
  • MRI (magnetic resonance imaging) of the head
  • SPECT scans—a CT scan variant that examines specific areas of the brain for blood flow and metabolism

After an anoxic brain injury, prognosis varies tremendously based on the severity of damage. Damage is often widespread, affecting major regions of the brain. In minor cases, a person may only suffer memory loss. In moderate cases, permanent effects ranging from cognitive deficits, muscle tremors, and seizures can occur. Anoxic brain injuries at birth can cause Cerebral Palsy (CP), a lifelong condition. In cases of severe damage, the patient may require placement in a long-term care facility. In the most severe cases, the patient may remain in a persistent vegetative state with the inability to regain consciousness.


Mt. Sinai Hospital

NYU Langone Medical Center

Types of Trauma that Cause Traumatic Brain Injuries

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Traumatic brain injuries (TBI) range widely in severity. More severe traumatic brain injury cases can have a permanent impact on a person’s physical coordination, cognition, memory, and muscle control. A head injury results from an outside force involving a direct blow or violent, jarring force to the brain. Brain tissue may be injured or even permanently damaged depending on the type and severity of the trauma. This type of injury can cause the skull to be fractured or penetrated, while the brain may endure tissue rupture, swelling, or bleeding.

Types of Trauma Associated with Traumatic Brain Injuries

Traumatic brain injuries are caused by the following types of trauma or impacts that affect the brain:

  • Direct Blow: A direct impact from a falling object or from the skull striking a hard surface such as pavement can cause the brain to bruise or swell. A blow from a sharp object can crush or penetrate the skull, resulting in an open head injury. Contact sports and physical assaults may also involve sharp, direct blows to the skull.
  • Jarring / Glancing Blow: An angular or glancing blow to the head or body may produce a strong enough acceleration or deceleration to jar the brain inside the skull. Violent, indirect forces can cause the brain to expand and contract inside the skull, similar to a ripple effect in ballistics gelatin. This type of blow can produce moderate to severe concussions and is common in contact sports. Football players who are hit/tackled from multiple angles may experience a head injury caused by these glancing blows.

Common Causes of Trauma and Resulting Head Injuries

The list below includes general situations which typically result in some form of traumatic brain injury (TBI):

  • Traffic Accidents: Collisions might involve two or more cars, motorcycles, bicycles or pedestrians. Traumatic brain injuries occur when a victim’s head strikes a dash board, concrete/pavement, or other solid surface as a result of a collision. A violent “whiplash” effect, may produce jarring forces strong enough to cause the brain to twist or collide with the inside surface of the skull.
  • Falls: Mayo Clinic statistics claim that falls are the most common source of traumatic brain injuries among the elderly and in young children. Falling from a bed, down stairs, off of a ladder or in the shower are all examples.
  • Explosions and Combat Injuries: Explosions from improvised explosive devices (IEDs) overseas are a leading cause of TBI among military personnel. An explosive blast can produce shockwaves strong enough to injure the brain directly. Explosions may also occur in certain types of industrial settings, such as mines or chemical plants.
  • Sports and Recreation Injuries: Many sports and certain recreational activities pose an increased risk of traumatic brain injuries due to their physical or extreme nature. Common examples include:
    • Football
    • Boxing
    • Lacrosse
    • Hockey
    • Skateboarding
    • Rock-climbing
    • Skydiving
  • Violence and Assaults: According to Mayo Clinic statistics, nearly 10% of all head injuries result from violent events such as gunshots, domestic violence or child abuse.


CDC – What are the Leading Causes of TBI

Mayo Clinic – Traumatic Brain Injury

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Coping with the Mental and Psychological Effects of a Traumatic Brain Injury

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Traumatic brain injuries (TBI) can result in certain types of short and long term complications. Common changes following a brain injury often include changes in the person’s mental and psychological state which affect personality and behavior. It helps for caregivers, family members and friends to be prepared for the mental and psychological effects a traumatic brain injury can have on their loved one.

What to Expect Regarding the Mental and Psychological Effects of a Traumatic Brain Injury

Depending on the area of the brain affected, a person who experiences a traumatic brain injury can exhibit changes, impairment, or imbalance within the brain’s centers responsible for emotion, mood, and feelings.

  • Short or long-term personality changes: A brain injury patient may become more or less outgoing, have sudden vocal outbursts, become withdrawn and less talkative or lose interest in his/her favorite activities.
  • Loss of mental filters: Patients may speak their mind or verbalize socially awkward or rude comments if the injury affected the part of the brain that tells them when to exhibit restraint or keep certain thoughts to themselves.
  • Emotional instability: Depression and anxiety result from changes in brain signals and can be influenced by different circumstances. Moods may linger for days or they can change abruptly in a few hours. Anxiety may range from general restlessness to full-blown panic attacks. A patient’s own frustration in self-recognition of the symptoms may cause feelings of further hopelessness and psychological duress.
  • Temperament/irritability issues: A patient may seem less tolerant of changes and stressful/busy environments, and may become argumentative or even uncharacteristically aggressive. Noticeable frustration and tolerance issues may be more prominent when the injured person is over-tired or under stress.
  • Difficulties with social cues: A brain injury patient may lose the ability to detect non-verbal cues such as gestures or facial expressions. The injured person may be unable to recognize when others are becoming uncomfortable or irritated or may fail to understand why people are smiling or laughing.

It’s important to understand that the injury is responsible for the behavior. Family friends are encouraged to simply support the recovering injury victim through patience and understanding while guiding that person with extra sensitivity.


Medical News Today

Mayo Clinic

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Common Types of Motorcycle and Bicycle Accident Injuries

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Motorcycle and bicycle accidents can involve abrupt collisions and potentially severe injuries to the rider. Even though motorcycles are faster and more powerful, a bicycle accident can be equally as devastating. A cyclist may crash or be struck by a motor vehicle while riding under 5 mph and can still sustain catastrophic, life-threatening injury. Wearing a motorcycle helmet reduces the rider’s probability of suffering a traumatic brain injury by at least 40% if he/she is involved in a crash. Additionally, nearly 75% of all head injuries caused by bicycle accidents can be prevented by the use of helmets.

Common Motorcycle and Bicycle Accident Injuries

For those riders and cyclists fortunate enough to survive a collision with an automobile, injuries may still be very painful or even permanent. Traffic accident survivors may still require treatment or hospitalization for flesh injuries, fractures, head injuries, or spinal cord injuries. Traumatic brain injuries and spinal cord injuries typically require in-patient rehabilitation and can leave riders and cyclists with permanent disabilities.

  • Bone Fractures: Colliding with a car or truck at any speed, or simply losing control and being ejected can fracture bones – particularly in vulnerable joints like the wrists and elbows. Unprotected knee caps can be broken or shattered, and riders who crash often suffer from bruised or fractured ribs. Compound-fractures which break the skin can damage muscles and ligaments and may impair a rider’s range of movement once they heal.
  • Soft Tissue Injuries: Road rash is a colloquial term used to describe a severe tissue or muscle injury caused by abrasion with the road. If a rider is ejected and slides across a pavement, the coarse surface is likely to tear away any exposed flesh. Most traditional clothing is quickly torn or pulled away by the road. Riders can don jackets equipped with protective polymer or Kevlar armor designed to withstand road friction and protect a rider’s flesh in case of a crash.
  • Spinal Cord Injury: In severe cases, the spinal cord may be pinched, crushed, or severed. The injury may result in total paralysis below the injury site. Paralysis of the lower body and lower extremities is called paraplegia, while paralysis in all limbs, with an injury site above the chest or shoulders is called quadriplegia. The effects of a complete spinal cord injury are permanent.
  • Traumatic Brain Injury (TBI)
    • Concussions: The majority of traumatic brain injuries are concussions. Helmets protect against damage to the skull, but a concussion may still be caused by an accident. A concussion occurs when the brain collides with the inner surface of the skull. Most concussions produce temporary effects which eventually subside with proper rest. Effects often include persistent headaches, problems with concentration, memory impairment, and balance/coordination issues.
    • Contusions: Contusions are bruises on the brain that form like bruises in the skin or muscles. Depending upon the region of the brain affected, bruising can produce effects similar to a concussion.
    • Hematomas: These are blood clots that occur between the skull and brain or inside the brain itself. Clots in the brain may block the supply of blood and oxygen to the brain, resulting in a stroke.



    Web MD

    Northeastern University

    Mayo Clinic Website

    Department of Veterans Affairs – TBI Symptoms & Screening

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Skateboarding Accidents – A Growing Contributor to Traumatic Brain Injury in Youth

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Traumatic Brain Injuries (TBI) result from some manner of force applied to the human head. In this respect, the word trauma refers to an injury cause by a physical force applied outside of the body. A direct impact or a violent acceleration/deceleration can cause the brain to collide with the inside surface of the skull. The majority of all traumatic brain injury cases involve concussions, particularly among youth.

TBI in children can produce serious damage in young, still-developing brain tissue. A large percentage of youth participation in sports like football and soccer contribute to a higher occurrence of TBI, mostly concussions, in adolescents and pre-adolescents. Most teens and pre-teens sustain concussions as a result of participation in contact sports and recreational activities such as biking, rollerblading, and skateboarding.

Skateboarding Now a Top-Choice Recreational Activity among Teens

Recent data gathered toward the end of 2013 concluded that skateboarding has become more popular than baseball among today’s teenagers. According to American Sports Data, last year, some 10.6 million teens under the age of 18 owned skateboards.

One of the factors believed to be behind the increase in catastrophic injuries and fatalities is a surge in the number or recreational skateboarders, according to a study released last month by the Journal of Trauma. In 2011, 52% of skateboarding injuries involve kids below age 15, with more than 78,000 injuries requiring emergency room visits, according to the American Academy of Orthopaedic Surgeons.

The National Safety Council says children and teens are no longer just being seen for minor sprains and fractures. Traumatic brain injuries and severe concussion, some resulting in permanent injury and death, are raising concerns among health care professionals. Skateboarding ranks fifth in the top 10 sports-related activities leading to head injuries in children ages 14 or younger.

The Consumer Product Safety Commission (CPSC) reported that more than 50% of all skateboarding injuries come from riding on irregular surfaces. Street riders are also contending with traffic at times, which can be a recipe for disaster. In response, many municipalities are building public skate parks – designated safe skating areas with dips, jumps, and regular angles better suited for skater safety.

Nearly 50% of skateboarding injuries also have some type of head injury involvement, according to Dr. Michael Webb, executive director of the NeuroTexas Institute at St. David’s HealthCare. Many studies and experience shows that injuries really run the gamut, from contusions, lacerations, Achilles ruptures, back muscle strains and sprains to fractures, concussions and other head injuries, knee injuries, calf muscle tears, rotator cuff injuries, stress fractures and overuse injuries.

A minor bruise, sprain, abrasion or small cut can be taken care of at home, but beyond that, parents should ensure their child is evaluated by a medical professional – especially in any case of a suspected concussion or head injury.

Treating Skateboarding Injuries and Preventing Head Trauma

Parents must understand that many skateboarding injuries require physical therapy to recover. It’s up to parents to make sure a recovering child sticks to the recovery plan and the schedule diligently prior to resuming any strenuous activity or before getting back on a board. A qualified physician will determine when rehabilitation is complete and when it’s okay to return to a sport or activity. This is especially important with any child recovering from a traumatic brain injury.

Prevention is a big part of safety in skateboarding. First, you need to know that the American Academy of Pediatrics (AAP) advises that children younger than 5-years-old should never ride a skateboard. The AAP also advises that 6-10-year-olds should never be allowed to skateboard without close supervision from an adult or an older child who the adults are confident is responsible enough to be left in charge.

Helmets are a must for skateboarding safety. The National Safety Council recommends choosing a helmet based on safety standards and one that is adjustable with strong straps and a buckle. Ask for help from a sales person to ensure the helmet is properly fitted. Loose helmets do very little to protect the head in the event of a fall. Also ensure any helmet bears a sticker that says it meets the ASTMF1492 skateboard helmet standard.


Coastal Point

Brain Injury Association of American

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Bicycle Accidents and Helmet Statistics

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In South Florida, bicycle accidents occur at a relatively high rate. Central and southern Florida’s major metropolitan areas are among the nation’s most dangerous areas when it comes to fatal bicycle accidents. A few different causes are common among many accidents between bicyclists and motor vehicles.

Bicycle helmet awareness has been a growing topic of discussion in recent decades. Most safety experts strongly support the use of helmets by cyclists at all times. The majority of traumatic brain injuries (TBI) stemming from bicycle accidents occur when helmets are not worn.

Sadly, many of these accidents involving head injuries result in permanent brain damage or even death. Bicycle helmets have been statistically proven to decrease the frequency and severity of traumatic brain injuries and death among bicyclists.

Bicycle Helmets and Accidents – Facts and Statistics

The following statistics pertain to bicycle helmets, head injuries, and helmet effectiveness:

  • In 2010, 616 cyclists were killed in traffic accidents. 429 were not wearing helmets at the time of the fatal accidents.
    726 bicyclists died on US roads in 2011.
  • The average age of a bicyclist killed on US roads is 43.
  • Nearly one fourth (23%) of the cyclists killed were drunk.
  • One drink increases a bicyclist’s probability of serious injury or death by a factor of six.
  • Four or five drinks increase the probability by a factor of 20.
  • Fatal crashes typically were urban and not at intersections.
  • Helmet use among those bicyclists with serious injuries was low (13%), but it was even lower among bicyclists killed (3%).
  • Only one fatal crash with a motor vehicle occurred when a bicyclist was in a marked bike lane.
  • At least 75% of all bicyclists who die in accidents each year die from traumatic brain injuries (TBI).
  • Each year, an estimated 67,000 cyclists visit an emergency room because of an accident-related head injury.
    A cyclist not wearing a helmet is 14 times more likely to die in a bicycle accident.
  • One cyclist is killed in a traffic accident every six hours in the United States.
  • According to the National Survey of Bicyclist and Pedestrian Attitudes and Behavior, only 50 percent of cyclists wear their helmets occasionally, while only 35 percent wear their helmets at all times.
  • Nearly 60 percent of all childhood bicycle-related deaths occur on minor roads. The typical bicycle/motor vehicle crash occurs within 1 mile of the bicyclist’s home.
  • Among children ages 14 and under, more than 80% of bicycle-related fatalities are associated with the bicyclist’s behavior, including riding into a street without stopping, turning left or swerving into traffic that is coming from behind, running a stop sign, and riding against the flow of traffic.
  • Bicycle helmets have proven to reduce the risk of head injury and the risk of brain injury.
  • Bicycle helmets have also proven to offer substantial protection to the forehead and mid-face areas.