Was My Loved One’s Diffuse Axonal Injury Treated Appropriately?


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In the United States, more than 1.5 million people experience traumatic brain injuries each year. Diffuse axonal injuries account for most of these cases, and severe brain injuries are frequently deadly, making early identification and treatment essential to survival.

What Is Diffuse Axonal Injury?

Diffuse axonal injury (DAI) is a common type of traumatic brain injury. It’s estimated that some level of DAI is present in about half of all severe head traumas. It occurs when the brain rapidly shifts inside the skull, causing microscopic tears in the brain’s connecting nerve fibers (axons). These axon injuries are “diffuse,” meaning they occur throughout the brain rather than localized to one particular region. This widespread brain damage can range from minor (many neurologists believe concussions are a mild form of DAI) to severe, resulting in coma or death. This kind of injury can have many causes, but the most common ways for a DAI to occur are by motor vehicle accident, falling, assault, sports-related injuries, or “shaken baby syndrome.”

How Is It Diagnosed?

Because tears in the brain’s axons are typically microscopic, they are not always evident on an MRI or CT scan. This makes it difficult to diagnose definitively, so a clinician must know what signs and symptoms to look for to provide appropriate treatment promptly. 

The most common initial symptom of DAI is loss of consciousness. In moderate-to-severe cases, this can take the form of a coma lasting 6 hours or more. If the DAI is mild, then the injured person may not lose consciousness but will display other signs of brain damage. Symptoms can be highly varied depending on what parts of the brain have sustained the most damage.

Common initial symptoms of brain damage include:

  • confusion
  • dizziness or difficulty maintaining balance
  • headache
  • nausea and/or vomiting
  • drowsiness
  • insomnia

Suppose someone is suspected of having a head injury and presents with any of the above symptoms (with or without loss of consciousness). In that case, they should immediately be evaluated for a traumatic brain injury.

How Is DAI Treated?

Unfortunately, brain cells are typically unable to regenerate after they’ve been damaged or destroyed. This means that, in most cases, brain damage is irreversible. As a result, treatment of DAI focuses on preventing further injury rather than repairing the injury that has already occurred. 

Brain injuries such as DAI are often accompanied by a dangerous drop in blood pressure, swelling around injured parts of the brain, and increased pressure within the skull. If these secondary problems can be quickly resolved or prevented, further brain damage can often be avoided or reduced.

While brain cells may not regenerate, this does not mean that full or partial recovery is impossible. With proper rehabilitation and therapy, other parts of the brain can often compensate for the damaged areas. Unfortunately, the degree of recovery (if it’s possible at all) cannot be predicted at the time of the injury, and it can sometimes take years of therapy to make any noticeable gains.

How Can a Doctor’s Negligence Affect A Patient’s Prognosis?

Often, a doctor inexperienced with head injuries will think that a CT or MRI of the brain is enough to diagnose or rule out a traumatic brain injury. While this is true for large, localized areas of damage, diffuse axonal injuries are typically microscopic and challenging (if not impossible) to detect by brain scan. If a doctor doesn’t think to evaluate their patient for a brain injury, they will not give the proper medications to prevent further damage.  

While it may be hard to believe that a doctor could miss that their patient has brain damage, it is often overlooked when other injuries are more apparent. For example, if a car crash results in broken bones requiring immediate surgery, the doctor may not think to evaluate for brain damage if there’s no apparent damage to the head. Even if a patient arrives at the hospital unconscious or with the previously mentioned symptoms of brain damage, it may be hours, or even days, before the patient is formally evaluated for brain damage. At that point, secondary damage has already occurred, and there’s nothing more a doctor can do. Thus, a doctor’s negligence can increase the risk of severe brain damage, coma, or death regarding DAI. 

Is My Loved One’s Death Or Severe Injury The Result Of A Doctor’s Negligence?

Due to the complex nature of diffuse axonal injuries, it can often be challenging to determine how much damage was done by the accident itself and how much occurred after admission to the hospital. If your loved one did not lose consciousness immediately after the accident, or if they seemed to develop more symptoms of brain damage (listed above) as time went on, then it’s possible that brain damage continued to occur after the injury. Likewise, suppose your loved one was discovered to have brain damage while recovering from an accident but was not evaluated or treated for it at the time of admission. In that case, it’s likely that brain damage was occurring while under a doctor’s care. If you have any concerns about the cause of your loved one’s brain injury or death, it’s crucial to get a second opinion.

I Think My Loved One Was the Victim Of Malpractice. What Now?

If you know or suspect that a doctor could have intervened and prevented further brain damage in your loved one, it’s important to find a experienced brain injury attorney as soon as possible. A legal team with proven track record in complex medical cases will be able to help you get a second opinion and can help uncover the truth about your loved one’s brain injury or death. Don’t delay, as the state of Pennsylvania has a two-year statute of limitations on medical malpractice cases like this. 

Why Choose Ross Feller Casey?

The legal team at Ross Feller Casey has extensive experience dealing with complex medical cases, including those involving diffuse axonal injury. We’re recognized as a leader in brain injury lawsuits throughout Pennsylvania and New Jersey, with an exemplary record of helping injured clients and their families. We have a team of Ivy League-trained doctors on staff to understand the medical complexities surrounding brain injury cases. As a result, our attorneys have recovered more than $3 billion for our personal injury clients, including over 50 $10-million-plus verdicts and settlements.

If your loved one was seriously injured or died as a result of a traumatic brain injury and you think a doctor’s negligence played a role, then you may be entitled to compensation. Contact our office today for a free case review, and let us help you get the justice you and your family deserve.

Disclaimer: Ross Feller Casey, LLP provides legal advice only after an attorney-client relationship is formed. Our website is an introduction to the firm and does not create a relationship between our attorneys and clients. An attorney-client relationship is formed only after a written agreement is signed by the client and the firm. Because every case is unique, the description of awards and summary of cases successfully handled are not intended to imply or guarantee that same success in other cases. Ross Feller Casey, LLP represents catastrophically injured persons and their families in injury and wrongful death cases, providing legal representation in Pennsylvania and New Jersey.