A blow to the head, or any other severe physical force, can deform, displace, and tear the tissues covering the brain and the brain itself. According to brain injury lawyer Doug Landau of the Herndon law firm ABRAMS LANDAU, Ltd., the injury and disability from this type of “inside” injury can be more devastating than a fractured skull. Tears in the “soft tissues” or “connective tissues” covering and protecting the brain may produce loss of function, necrosis, and hemorrhages.
Head injuries can be classified as:
(a) Closed: when a blunt object damages the brain and its coverings without actually perforating the skull or dura. The closed type of injury constitutes the majority of civilian injuries. Extensive intracranial damage may result from an injury to the head which produces little damage to the outside. Instead, the force may be communicated through a rigid, bony vault (calvarium) to the soft tissue within.
(b) Penetrating: when the skull and brain are directly lacerated by an object, such as a bullet or a knife. Brain injury lawyer Doug Landau notes that when the skull is pierced by a penetrating object that needs to be surgically removed, it is sometimes called “Excaliber Syndrome.” While working at Columbia Presbyterian Neurological Institute in the 1970s, Landau witnessed just such an extraction, as well as “penetrating” head injuries sustained by New York City Police and Law Enforcement Officers. Even when the injury to the brain was not readily apparent, the object (in one case, a metal pipe) was easily observed on the x-rays.