Traumatic lesions, whether they are the product of closed or penetrating injuries, and whether they are coup or contra-coup, may be said to have direct effects, and secondary effects. Brain injury lawyer Doug Landau notes that it is important to have an experienced specialist examine and test for the subtle effects of a closed head injury and brain trauma. Direct Effects of head trauma and brain injury are listed below:

A. DIRECT EFFECTS

1. Skull fracture

2. Hemorrhages–epidural, subdural, subarachnoid or parenchymal

3. Lesions to brain–contusion, laceration [ the most minor “lesion” has no identifiable gross or microscopic counterpart in human material and is the concussion which produces unconsciousness].

4. Diffuse axonal injury [DAI]