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Doug Landau
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High Speed Car Crashes Often Result in Diffuse Axonal Injury ("DAI")

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Diffuse axonal injury (DAI injury) is widespread injury to axons, a part of the nerve cells in the brain.

Nerve impulses leave nerve cells through a part of the nerve cell called the axon. In diffuse axonal injury, axons throughout the brain are damaged. That is because the brain moves inside the skull. If the brain moves, twists or torques too much, the nerve axons can stretch and tear. The usual causes include falls and motor vehicle crashes. As a result of diffuse axonal injury, brain cells may die, causing brain swelling, increasing pressure within the skull. Increasing pressure may compound the injury by decreasing blood supply to the brain. Sometimes the person has symptoms of damage to a specific area of the brain. Increased pressure within the skull may cause coma. Computed tomography (CT) scans or magnetic resonance imaging (MRI) is usually done to detect diffuse axonal injury. Diffuse axonal injury is treated with the general measures used to treat all types of head injuries. Surgery is not helpful.

Diffuse axonal injury (DAI) is a frequent result of traumatic deceleration injuries and a frequent cause of persistent vegetative state in patients. DAI is the most significant cause of morbidity in patients with traumatic brain injuries, which most commonly result from high-speed motor vehicle accidents.

DAI is a significant medical problem because of the high level of debilitation that is suffered by the patient, the stress that must be endured by the patient’s family when the patient is in a persistent vegetative state, and the staggering medical cost of sustaining the patient in this state.

The true extent of axonal injury typically is worse than that visualized using current imaging techniques. In other words, many cases of DAI will result in Microscopic tears, so you will not see them with the medical tests currently available. Autopsy and histopathic studies have shown that the extent of DAI always exceed that visualized macroscopically, and DAI are usually Non-Hemorrhagic, so there is no bleeding, so bleeding tests will show zilch. Neuropsychological testing can sometimes show the damage from "closed head injury" or traumatic brain injury ("TBI"). The complexity of these types of injuries and their difficulty in being "seen" or diagnosed require that an experienced lawyer be retained at the earliest possible by brain injury victims and their families.