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Head injury is a potentially-disabling condition that may include the head, brain, scalp and skull. Head injury is often referred to as TBI, although TBI is specifically injury to the brain through an event that damages the head.

Traumatic brain injury (TBI), and head injury is a major cause of death and disability, due to falls, vehicle accidents and violent acts, as well as sports injuries. Damage to the brain can occur by impact or acceleration directly, or as a result of a head injury. The delayed effects of head injury on the brain may become an additional contributing factor to eventual disability, as brain trauma may not appear for hours, or days, after the incident.

Traumatic brain damage can cause behavioral, cognitive, emotional and physical difficulties, and may result in permanent disability or death.

Diagnosis for head injury, brain injury and traumatic brain damage include CT scans, MRI, xray and observation. All emergency room and treating physician and specialist documentation is critical to your long term disability claim determination.

Treatment for traumatic brain injury includes interventive medications, emergency surgery, scheduled surgeries, physical therapy, vision and speech therapy, and long term rehabilitation, often with uncertain results.

Traumatic brain injury (TBI)

Is also classified by pathological features, and occur as lesions. Lesions may be extra-axial (occurring within the skull but outside the brain), or intra-axial, (occurring within the brain tissue.) Damage from TBI may be confined to a specific area (focal) or distributed (diffuse). It is common for both types of injury to occur in conjunction, causing overlapping symptoms.

Diffuse injury includes concussions and diffuse axonal injury, with widespread damage to axons, white matter and cerebral hemispheres (brain regions.)

Focal injuries are damage-specific, causing functional damage to specific area of the brain. Focal injury commonly affects areas of the brain responsible for social behavior, emotion regulation, olfaction and decision-making. Motor skills and speech may also be impaired.

Cerebral laceration is a type of focal injury caused by torn tissue. This type of injury may, or may not, cause blood to mix with tissue. Whereas hemorrhage resulting in bleeding is called Hematoma. All of these types of damage to the brain can cause short and long term conditions that are potentially disabling.


Traumatic Brain Injury results in a variety of symptoms that are often indicative of the type of damage (focal or diffuse.) Unconsciousness is a first response to traumatic brain injury, and usually lasts longer after damage to the left side of the brain. Mild brain damage  include headache, vomiting, nausea, dizziness, changes in motor coordination, imbalance, ringing in the ears, fatigue, lack of coordination, bad taste in mouth, sleep disorders and lethargy.

Moderate to severe brain injury may also result in inability to wake, convulsions, dilation of pupil(s), slurring, language difficulties, muscle weakness, numbness of limbs, confusion, agitation and restlessness.

Patients may also experience mood changes, behavioral disorders, memory and concentration problems, and lack of judgement and attention. Alexithymia, difficulty identifying, and processing emotions, is apparent in more than 60% of patients diagnosed with TBI.


Increased pressure within the skull can cause decreasing level of consciousness, paralysis, weakness on one side of the body, and pupil damage; Cushing’s triad (high blood pressure, slow heart rate, and respiratory depression); Aniscoira (difference in pupil size), and abnormal positioning of the limbs (posturing.)

All of these symptoms can affect the ability to work, as well as quality of life, and are legitimate considerations in the long term disability claim process.