Head Injuries

March 11, 2010

Traumatic brain injuries can be classified as two basic types. Closed head injuries and open head injuries. In open head injuries, the skull which protects the brain has been penetrated. In closed head injuries, there is no penetration into the skull but the injury occurs because of forces and deformation of brain tissue as it moves within the skull. Parts of the interior surface of the skull are rough and acceleration and deceleration of soft brain tissues can be injured by impacting with the harder surfaces of the skull.

In addition to these two basic types of traumatic brain injury, brain injuries are often qualified as mild, moderate or severe. While there are varying standards of what these categories mean, generally speaking mild head trauma includes a Glasgow Coma Scale between 13 and 15, with a loss of consciousness for 20 minutes or less with no deterioration of the Glasgow Coma Scale, no focal or neurological signs and no intercranial lesions.

Moderate traumatic brain injury is generally classified as Glasgow Coma Scale between 9 and 12, greater than 6 hours with complications or focal brain lesions on scans. Sometimes this classification is also used when there are periods of unconsciousness of more than 30 minutes where the Glasgow Coma Scale recovers more quickly than 6 hours. If coma hasn't been induced but recovered from within a 6 hour time frame, moderate is the most common description of the injury.

Severe traumatic brain injury is usually classified as a Glasgow Coma Scale between 3 and 8 with resulting coma and the duration of more than 6 hours.
The Glasgow Coma Scale is widely used scoring procedure to determine neurological status following traumatic injury in the western world. It is generally noted by emergency medical services at the scene of the incident. It is often repeated in emergency departments that receive trauma patients. It should be noted that the Glasgow Coma Scale is not necessarily predictive of the ultimate outcome of the patient, particularly at higher scores. A score of 15, the maximum Glasgow Coma Scale does not preclude mild head injury or neurological deficits. The Glasgow Coma Scale is obtained by assigning point values 1 through 4 regarding eye opening, 1 through 5 regarding verbal response, and 1 through 6 regarding best motor responses.

There are other scales used to assess acute injury and longer term injury. However, the Glasgow Coma Scale is the most widely used scale in the early stages of brain injury.

The lawyers at Tatlow, Gump, Faiella & Wheelan LLC have many years of experience handling claims involving traumatic brain injuries. Visit our TGFW Brain Injury Center for additional information.