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What Is the Difference Between Open and Closed TBI?


Traumatic brain injuries (TBIs) occur when trauma is inflicted on brain tissue. This can affect cognitive ability, memory and other basic functions. In some cases, TBIs can even be fatal. Doctors and other health professionals distinguish between open TBIs and closed TBIs.

Open and Closed Traumatic Brain Injuries (TBIs)
TBIs can result from something as simple as a bump or a blow to the head or a sudden jolt. Every year in the United States, almost 1.5 million people suffer traumatic brain injuries. About 50 percent are severe enough that people need to go to the hospital. The worst forms of TBI can lead to permanent brain damage or death.

Often, TBI symptoms do not appear for days or weeks after a blow to the head. Some of the most common head injury symptoms include:

  • Loss of consciousness, sometimes for extended periods
  • Headaches that do not go away, but grow worse with each passing day
  • Seizures or convulsions
  • Dizziness
  • Frequent vomiting
  • Ringing in the ears
  • Unexpected fatigue
  • Sensitivity to light
  • Difficulties waking up
  • Arms and legs that feel weak or numb
  • Dilated pupils
  • Slurred speech

Table of Contents

What Is an Open TBI?

What Is a Closed TBI?

What Types of Closed TBIs Are There?

Are Closed TBIs Considered Permanent Injuries?

What Are the Main Causes of a TBI?

Can You File a Claim for a Concussion or Other Closed TBIs?

Why Should You Hire a Lawyer If You Have Suffered Either an Open or Closed TBI?

Let KBG Injury Law Help You If You Have Suffered a TBI


What Is an Open TBI?

An open TBI occurs when the skull gets fractured, penetrated or otherwise broken in some way. This type of injury is also called a penetrating head injury. A penetrating TBI can happen in a car accident if a piece of metal or other sharp object hits a passenger with enough force to penetrate the skull. It can also happen with fireworks injuries, gun injuries and more.

An open TBI usually results in significant injury to the brain, especially if the penetrating object enters the brain tissue and causes severe trauma. In these cases, the damage can stay localized to the area affected by the foreign object. However, the overall injury can also cause swelling of the brain and other dangerous conditions. The symptoms of an open TBI can vary depending on how much of the brain becomes damaged and which specific parts get injured.

What Is a Closed TBI?

A closed traumatic brain injury occurs when a patient strikes their head or gets hit in the head, but the skull remains intact. Sports-related severe head injuries, for example, are often closed TBIs. The danger with this type of injury is that the damage can be extensive and diffuse. Damage usually occurs because the brain tissue strikes the inside of the skull during impact, potentially leading to bleeding, bruising, swelling and other damage at the points where the brain impacts the skull.

A closed TBI occurs when a patient strikes or gets hit in the head, but the skull remains intact.

In some cases, the brain bounces off one area of the skull and strikes another area. For example, someone who gets forcibly struck to the front of the skull may experience bruising or bleeding, both at the front and the back of the skull, as the brain reverberates back and forth. The severity of injuries and the symptoms involved will depend on which specific areas become affected and how hard someone gets struck in the head.

What Types of Closed TBIs Are There?

There are several types of TBIs that can affect a person.

What Types of Closed TBIs are there?

Of course, one way we can classify a head injury is the open vs closed TBI distinction. However, there are some more specific types that are especially important when it comes to closed TBIs. Types of closed TBIs include concussions, contusions and diffuse axonal injuries:

  • Concussion: Concussions are the most common type of TBI. They can be caused by both open and closed head injuries. A concussion occurs when an impact to the head or sudden motion causes damage to the blood vessels in the brain. A concussion can also entail complications like swelling or bleeding of the brain. A concussion can cause a person to blackout, but this doesn’t always happen. Some people will feel dazed.
  • Contusion: A contusion refers to bleeding that occurs on the brain. This is a serious issue that can also occur with open TBIs. Sometimes, surgery is required to remove a contusion. A coup-contrecoup injury is a specific type of contusion, one in which the brain bleeds at the spot where the brain is impacted and on the opposite side due to it hitting the skull.
  • Diffuse axonal: A diffuse axonal injury happens when the head is shaken rotated violently, as you see with Shaken Baby Syndrome and some car accidents. With a diffuse aconal injury, the nerve tissue in the brain tears as the skull moves. This can interfere with the brain’s function and its chemical process. This type of injury is quite serious and can sometimes be fatal.

Are Closed TBIs Considered Permanent Injuries?

Yes, they can be. A closed brain injury can be quite damaging.

The symptoms of a closed TBI are similar in many respects to that of an open TBI, but with a few extra symptoms you need to watch for. These include:

  • Trouble breathing
  • Brain fluid leaking from the ears or nose
  • Trouble seeing correctly
  • Emotional or behavioral changes

Both how fast you recover and how much of your original health you recover depends greatly upon the circumstances of how you suffered the injury in the first place. Often, the amount of time spent in a coma or the amount of normal activity recovered in the first few weeks are significant indicators of the severity of any closed brain injury. The length of time a patient is in a coma and the length of time it takes to recover normal activity are both considered signs of much more severe brain trauma.

What Are the Main Causes of a TBI?

Almost 1.5 million Americans suffer traumatic brain injuries every year.

As we noted above, almost 1.5 million Americans suffer traumatic brain injuries every year. Of that total, about 50,000 die and 85,000 end up suffering permanent injuries and disabilities. Currently, about 5.3 million Americans have permanent disabilities from TBIs.

Although many things can cause a traumatic brain injury, the three most common causes are vehicle accidents, gun shots, falls and other accidents. While TBIs can also result from medical conditions, such as a tumor or a stroke, accidents are still the primary cause.

1. Vehicle Accidents

Remember, your brain is soft, while your skull is quite durable and inflexible. When you are in a car accident, your brain travels at a different speed than your skull does because of its gelatinous nature. As a result, if your head strikes an object during a car accident, or suddenly accelerates and stops — as in a case of whiplash — your brain can slam into your skull, causing brain injury. If the impact is strong enough, many of your brain’s nerve cells can suffer significant or even permanent damage.

2. Gun Shots

It is estimated that 35% of all TBI deaths are caused by gunshot head wounds. Gunshot wounds are an especially serious problem among urban residents who deal with issues of gang violence and higher homicide rates. Needless to say, gunshots to the head are serious injuries that few people can survive. A gunshot wound is an example of a very serious open TBI.

3. Falls

One of the other main causes of traumatic brain injuries is a fall. Falls happen every day, but some are serious enough to cause serious problems. Some examples of falls that might result in a TBI are falling off a ladder, falling from a scaffold or even falling down the stairs. It doesn’t necessarily need to be a fall from a great height. All it takes is an impact to the head to potentially result in a TBI.

4. Workplace Hazards

A worker can trip, fall or slip while on the job and hit their head. You could also be hit in the head by falling debris. While helmets are designed to provide some protection, they can fall short in protecting you from falling materials or tools as they should. Construction workers, warehouse workers and employees in large retail stores are all at risk of being hit by some form of debris. Nearly all workplaces contain some hazards, and some of these can result in TBIs for employees.

5. Sports

Most people are aware of the NFL’s highly reported issue of former players with TBIs, but TBIs can happen in many other sports as well: hockey, soccer, rugby or boxing, for instance. Basically, the danger of a TBI increases in any sport that features high-impact collisions. As an athlete’s head collides with another player’s helmet, the ground or any other surface, their brain can bounce against their skull, causing a concussion or a more serious form of TBI.

Can You File a Claim for a Concussion or Other Closed TBIs?

If you suffered a concussion after an accident, you may be able to make a claim.

If you have suffered a concussion after a motor vehicle accident or a workplace incident, you may be able to make a claim, based on both the medical injuries you sustained and any emotional pain or suffering you experienced. However, you will need to prove another party was responsible for the accident, and it is essential to have medical evidence to support your claim.

Remember, concussions are like many medical injuries. They do not always appear right away. Post-concussion syndrome affects about 10 percent of people who have suffered a TBI. These symptoms can last for many weeks or even months once they appear.

If your post-concussion syndrome is the result of a vehicle or workplace accident, the key to filing a successful claim is the medical report. If the doctor believes your symptoms stem from the accident in which you suffered a TBI, that creates a solid basis for a claim or lawsuit.

Normally, someone who has filed a claim for damages based on a TBI-related medical condition can only do so if their physician believes the accident that led to the TBI caused this condition, and can offer medical proof. If you have suffered a concussion, however, and your doctor does not believe any related symptoms are the result of a vehicle or workplace accident, you cannot start a claim for damages.

You may go to another doctor for a second opinion, though.

If you do make an accident claim, it should also include compensation for any pain or suffering, depending on any testimony you might give and any medical evidence your doctor could present. The doctor needs to be able to definitively show you have suffered a concussion, this concussion resulted from your vehicle or workplace injury and any of the symptoms mentioned above are a result of this traumatic brain injury.

The most significant detriment to filing a claim involving post-concussion syndrome is that the symptoms can be hard to detect or blame on a brain injury. It will occasionally make settling with an insurance company difficult, because those companies want any claim to be straightforward with obvious medical problems. Normally, insurance companies will not offer adequate compensation for anyone suffering from a concussion or a TBI, and it is very likely you will need to go to trial.

If you do find yourself in court over a claim, it is vital to explain your symptoms and medical issues as clearly as possible. The jury will want to know how long you been suffering from the symptoms, how they have negatively affected your life and if they are disabling in any way. When you consider these factors — as well as the general truth that you should never represent yourself in a trial — you can see why it is so important to work with a lawyer if you have filed a claim based on post-concussion syndrome caused by a TBI.

Why Should You Hire a Lawyer If You Have Suffered Either an Open or Closed TBI?

Severe or permanent brain injuries face numerous difficulties to overcome when filing a claim. Since most insurance companies won’t settle, or settle for much less, with someone who suffered a TBI, you should hire a traumatic brain injury lawyer to help you in this case.

1. TBI cases are complex and difficult to prove.

As noted above, both medical and legal issues are involved with proving a TBI claim. Juries understand much more clearly if someone has filed a claim for a broken arm or a leg or an injured back. Proving to a jury or a judge that you have suffered serious consequences because of the TBI requires the expertise of a legal team who have dealt with these issues before.

2. A TBI claim can be costly to litigate.

If you are going to prove your TBI led to your post-concussion syndrome and it has severely affected your life and your earning ability, you are going to need lots of medical and legal help that can be a challenge to pay for out of pocket. In most cases, attorneys will not charge a fee unless they have successfully argued your case. If your TBI has led to financial difficulties, work with your lawyer on a payment plan.

3. No one can take advantage of you.

Suffering a brain injury is no small thing. If you look over the symptoms listed above, it is easy to see how a claimant with a TBI can suffer memory lapses and have difficulty concentrating. It is the sort of thing an insurance company will take advantage of if you do not have someone looking out for your best interests. When you work with a trusted lawyer who has experience dealing with TBIs, no insurance company will be able to walk over you.

4. A lawyer will make sure any settlement will fairly compensate you.

When someone has been suffering from post-concussion syndrome or even a more severe TBI for any extended period, the normal human reaction would be to try to settle as soon as possible. But this is one way in which a lawyer can protect their client. Even if the insurance company has offered a relatively large settlement amount, it is the lawyer’s job to make sure that sum of money will help their client with medical bills and lost wages for the duration of the time they are incapacitated.

Let KBG Injury Law Help You If You Have Suffered a TBI

If you have sustained a TBI, it is essential to seek immediate medical attention and legal representation. Contact KBG Injury Law if you would like to speak with an attorney in Pennsylvania about your situation.

Contact us to speak with a head injury attorney about your situation.

You can call us at 800-509-1011 or visit our contact us page and tell us why you wish to file a claim. One of our team of experienced TBI lawyers will contact you as soon as possible.

During this challenging time, our attorneys are advocating more than ever. While our physical offices are closed, we are all working remotely to ensure you still get the Results You Deserve. To all of our current clients, you can connect with us the same way you always do via email, phone, fax or text. To all of our prospective clients, the best way to get in touch with us is by using our contact form or by calling (800) 509-1011

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