Diffuse Axonal Brain Injury

Suffered a Diffuse Axonal Brain Injury? Our Firm Can Help

Diffuse axonal injury (DAI) is a form of traumatic brain injury (TBI) that occurs when nerve cells in the brain tear or detach. Studies have shown that between 40% and 50% of TBI patients that are admitted to hospitals have suffered diffuse axonal injuries. It has been estimated by the CDC that in the United States of America, there are over 1.5 million reported traumatic brain injury cases every single year.

DAIs can have a profound impact on an individual’s ability to live and work. If you have suffered DAI as a result of the wrongful actions of another, you may be entitled to compensation.

Because some cases of DAI are caused by another party’s poor decisions, it can also form a part of the compensable damages in a personal injury action. If securing legal counsel to protect your rights is necessary, our team of experienced anoxic brain injury lawyers is ready to fight for you to recover the maximum compensation owed to you.

We offer a sound, team-oriented approach when handling personal injury cases involving cerebral anoxia. Not only can our attorneys aggressively advocate for you in settlement or trial, but they can also guide you through the entire process with compassion and empathy.

Talk to a Los Angeles axonal brain injury lawyer about your case or contact our firm to schedule a no-cost consultation.

(323) 653-6311

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What is a Diffuse Axonal Injury?

A diffuse axonal injury (DAI) is a traumatic brain injury that occurs as a result of trauma to the brain. Diffuse axonal injuries are frequently the result of a traumatic acceleration/deceleration or rotational injury. These injuries lead to the shearing of connecting nerve fibers, known as axons, when an unmoving brain lags behind a moving skull.

Axons are the elongated projections of nerve cells in the brain. They transmit information to other brain cells, glands, and muscles around the body through electrical impulses. When axons are damaged as a result of an injury, they are ripped and spread out across the brain. This alters their ability to send signals to other areas of the body and can result in life-long injuries or even death.

The effects of diffuse axonal injuries can include swelling of the brain and increased skull pressure. This can result in a decreased blood supply to the brain, loss of consciousness, and even a coma. 

DAI is usually considered a primary brain injury, as the damage is typically sustained almost immediatel. However, there are various secondary injuries that may also be experienced, such as intracranial hypertension, edema (swelling), and hypoxia (lack of oxygen). One of the characteristic microscopic signs of axonal injury are swellings known as retraction bulbs. It has been suggested that these swellings prevent axon regeneration

What Causes A Diffuse Axonal Injury?

Diffuse axonal injuries occur when a force moves the head and/or body at a speed that causes the brain to move around the skull, shearing axons in the process. This is known as an acceleration/deceleration or rotational injury. 

A DAI can result from motor vehicle collisions. This can occur to persons inside the vehicle or to those struck by one. They can also occur during falls, sporting events, motorcycle accidents, or boating incidents.

Symptoms of a Diffuse Axonal Injury

Physical Symptoms

Some persons who have suffered a DAI will experience physical symptoms as a result of their injuries. Those  symptoms include:

  • Headaches
  • Dizziness
  • Fatigue
  • Vomiting

Those with more severe injuries may also suffer from:

  • Poor balance and coordination
  • Decreased motor skills
  • Swallowing issues
  • Tremors
  • Paralysis

People can also experience sensory and communicative deficits depending on which axons have been affected. Sensory issues can affect any and all of the senses, including problems with vision, smell, and hearing.

Cognitive Symptoms

After a traumatic brain injury, people can have issues with their memory, thinking, and problem-solving. They may also experience general confusion, problems with learning and retaining new information, and become socially withdrawn.

Some data suggest that DAI can initiate neurodegenerative processes that can cause and/or contribute to the development of dementia, Alzheimer’s disease, and Parkinson’s later in life.

Behavioral & Emotional Symptoms

As a result of axonal shearing following an injury, a person’s behavior may change significantly, if the regions of the brain that were damaged are those involved in personality. For instance, damage to the prefrontal cortex can lead to changes in a person’s ability to regulate his or her emotions or respond appropriately in different situations. Exacerbating this is the fact that often those who have suffered a brain lesion may not even be aware of or able to appreciate how their behavior has changed following their injury. The classic case of Phineas Gage is often used as a stark example of dramatic personality changes following a traumatic brain injury.

Behavioral changes can include:

  • Impaired social capacity
  • Difficulty forming and maintaining interpersonal relationships
  • Difficulties deciphering and responding to nuances in social interactions

All of these behavioral symptoms can make it much harder for those who have suffered a DAI to function in their day-to-day lives.

Persons who have suffered diffuse axonal injury can also experience profound emotional changes, including:

  • Temper flare-ups
  • Low frustration tolerance
  • Irritability
  • Anxiety
  • Depression

This constellation of symptoms can dramatically impact a person’s quality of life, as well as his or her ability to work and earn a living. In situations where DAI is the result of another party’s wrongful conduct, you may be entitled to compensation for pain and suffering, medical bills, and lost earnings. Speak with one of our experienced Los Angeles traumatic brain injury attorneys to find out what options may be available to you.

Long-Term Effects of a Diffuse Axonal Injury

Sadly, many of the previously mentioned physical, cognitive, and behavioral symptoms can remain for the entirety of a person’s life.

Levels of Severity of a Diffuse Axonal Injury

There are three severity levels, or grades, that DAIs can be classified under.

The first level is Grade 1. Diffuse axonal injuries meet this criteria when the axonal damage is confined within the white matter of the cerebral cortex and gray-white matter interfaces. Impairments can include brief loss of consciousness, pupil dilation, and the decline in cognitive domains such as calculation and memory.

Grade 2 injuries include when focal lesions and hemorrhages are present as a result of tissue tearing, in addition to the axonal damage present in Grade 1 injuries.
The final and most severe classification is Grade 3. Injuries enter this grade when all criteria from Grades 1 and 2 are present, with additional tissue tear hemorrhaging in the brain stem. Persons with a Grade 3 injury typically fall into a coma while exhibiting decerebrate or decorticate (abnormal) posturing.

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Treatment and Rehabilitation of a Diffuse Axonal Injury

There are various forms of rehabilitative care that one can undergo after suffering a DAI. Unfortunately, and while the rehabilitative care can be beneficial, on many occasions the symptoms stemming from a DAI are permanent. 

Prognosis of a Diffuse Axonal Injury

If a person has suffered a very mild DAI, his or her recovery process may look similar to someone who suffered a concussion. This would include a monitored rest period followed by medically-led rehabilitation.

In more severe cases, patients may fall into a coma. In these circumstances, doctors can only monitor the patient and wait to see if they regain consciousness. If they do, the patient will undergo intense rehabilitation in order to regain as much physical, cognitive, and behavioral functionality as he or she possibly can.

There are several traumatic brain injury and diffuse axonal injury rehabilitation programs. Those programs typically include supervision by a vast array of skilled professionals, including:

  • Psychiatrists
  • Physiatrists
  • Physical therapists
  • Speech and language therapists
  • Dietitians
  • Respiratory therapists
  • Neurologists
  • Neuropsychologists

The overall cost of full rehabilitation after a DAI can vary from person to person. Sometimes the cost is well into the millions of dollars. 

Compensation & Liability For Diffuse Axonal Injuries

Our firm stands ready to help you or your loved one get the compensation and closure they deserve in the aftermath of a DAI. For more information on the legal implications of brain injuries, visit our traumatic brain injury page.

(323) 653-6311


Banner image from Unsplash

Armen Akaragian | Los Angeles Personal Injury Attorney



Admitted to practice in 2006, Armen has arbitrated, tried, and settled several cases which have resulted in multi-million dollar verdicts and settlements.

Sources cited in this article:

  1. An Overview of Diffuse Axonal InjuryBrain Injury Association of America
  2. Diffuse Axonal InjuryNCBI
  3. Intracranial pressureWikipedia
  4. Cerebral HypoxiaCleveland Clinic
  5. Disorganized microtubules underlie the formation of retraction bulbs and the failure of axonal regenerationNCBI
  6. Axon Regeneration and the CytoskeletonCytoskeleton, Inc.
  7. A Simple Note On Acceleration And DecelerationUnacademy
  8. Diffuse Axonal InjuryScience Direct
  9. Prefrontal cortexWikipedia
  10. Can a brain injury change who you are?The Conversation
  11. Neurobiological consequences of traumatic brain injuryNCBI
  12. Diffuse Axonal InjuryTeach Me Surgery
  13. Decerebrate and Decorticate PosturingNCBI
  14. Therapy Development for Diffuse Axonal InjuryNCBI
  15. Diffuse Axonal InjuryUK Healthcare


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