When a head is twisted violently, such as in a car crash, microscopic brain structures, called axons, can tear.  The damage to the brain is a called a "diffuse axonal injury," or DAI.  When the axons tear, chemicals that were contained in those structures can leak into the brain tissue.  The torn axons and chemicals in the brain tissue disrupt the brain’s regular processes.  

The injury has been named "diffuse" because it was believed the damage occurred throughout the brain, and not in any one particular location.  We now know that that isn’t quite right.  For example, in severe cases, the axonal injury appears on an MRI.  When it does, it usually appears as one small foggy area.  (Seen in the center of the graphic as an opaque area.)   In fact, as it turns out, the damage caused by a "diffuse axonal injury" is usually centered in a specific part of the brain called the corpus callosum — the bundle of fibers that connect the two-halves of the brain. 

Victims suffering from DAI often have cognitive problems such as:

  • lack of concentration
  • poor long-term memory
  • difficulty dealing with more than one thing at a time,
  • lack of attentiveness
  • trouble keeping track of appointments, and
  • disorganization.

A victim can suffer a diffuse axonal injury even if there wasn’t any impact to the head. Because there is no tell-tale external bruising or bleeding, and because the DAI doesn’t always appear on an MRI, health care providers sometimes fail to diagnose the injury initially.  To represent an accident victim effectively, the personal injury attorney must be alert to symptoms which may suggest that the client should seek further medical evaluation.