Secondary brain injury

Decoding the Mystery: What is a Secondary Brain Injury?

As a seasoned personal injury lawyer at The Law Offices of Jared Spingarn, P.A., also known as Hire Jared, I often find myself speaking with clients who are grappling with a world turned upside down by a sudden, profound injury. “What is a secondary brain injury?” they ask, eyes wide with concern, desperate to understand their or their loved one’s diagnosis. Today, we’re going to shed light on this enigmatic term and explore what it means for those embroiled in a personal injury case.

A secondary brain injury is a complex medical concept that often remains overshadowed by the more immediate and apparent trauma. Like a lurking storm brewing on the horizon while the sun shines brightly overhead, it’s a phenomenon that is easily overlooked in the initial aftermath of an accident, only to manifest later with potentially devastating consequences.

Let’s unravel the mystery of secondary brain injury, distinguishing it from its primary counterpart, and discover why understanding this medical condition is essential for anyone dealing with the aftermath of brain trauma.

The Storm’s First Wave: Understanding Primary Brain Injury

What is a Secondary Brain Injury

To understand what is a secondary brain injury, we first need to define its precursor, the primary brain injury. This is the “storm’s first wave” — the initial, direct damage caused to the brain at the moment of impact or trauma. It can occur in a myriad of ways: from a sudden jolt in a car accident, a harsh fall, or even a violent act such as a gunshot wound. Primary brain injury refers to the immediate and localized harm to the brain’s tissue.

A primary brain injury occurs instantly, a product of the sudden and profound injury inflicted at the moment of the incident. It can result in a range of traumatic brain injuries, such as skull fractures, or a diffuse axonal injury, a type of closed brain injury where the brain’s long connecting fibers are sheared off as the brain is jolted inside the bony skull.

But what happens when the storm’s first wave recedes? Does the trauma end there? Unfortunately, the answer is no. The aftermath of the primary brain injury can lead to a complex cascade of events that culminate in secondary brain injury.

A Darker Storm: What is a Secondary Brain Injury?

Unlike a primary injury which occurs at the moment of trauma, a secondary brain injury is a process that unfolds over time following the initial trauma. This is the “darker storm” that comes in the aftermath. Secondary brain injuries occur due to a complex chain of physiological processes initiated by the initial trauma. These processes can lead to further destruction of brain cells and tissue, dramatically amplifying the effects of the primary injury.

Common causes of secondary brain injuries include:

  • Intracranial pressure: This refers to the pressure within the brain, which can increase due to cerebral edema or brain swelling. High intracranial pressure can reduce blood flow to the brain, leading to brain damage.

  • Ischemia: This is a condition where there is insufficient oxygen supply to the brain. Ischemia can lead to brain tissue death.

  • Excitotoxicity: Following a traumatic brain injury, an excessive release of neurotransmitters can overstimulate the brain cells leading to their damage or death.

  • Metabolic changes: A head injury can trigger changes in the body’s metabolism, which can contribute to cell death. This includes conditions like hyperglycemia, and excessive carbon dioxide levels.

Now that we understand the chain reaction that leads to secondary brain injuries, let’s delve into the symptoms and diagnosis.

Detection: Diagnosing Secondary Brain Injury


Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans are often used in the diagnosis of secondary brain injuries. These imaging techniques can reveal underlying fractures, intracial hemorrhage, or cerebral edema that might have occurred as a result of the initial injury.

Symptoms of secondary brain injuries can be both physical and cognitive, such as:

  • Memory loss

  • Difficulties with attention and concentration

  • Headaches

  • Seizures

  • Mood changes

For a deeper understanding of the symptoms and diagnostic processes for Traumatic Brain Injury, click here.

Consequences and Rehabilitation

The consequences of a secondary brain injury can be severe and long-lasting. Patients may suffer from functional deficits, and a thorough evaluation using tools like the Glasgow Coma Scale and the Disability Rating Scale can be used to measure the extent of these deficits. Rehabilitation is a key part of recovery, and brain injury rehabilitation programs aim to improve the patient’s ability to perform daily activities.

In summary, secondary brain injuries are a complex aftermath of an initial trauma that can lead to extensive damage if not recognized and treated promptly. Therefore, understanding the difference between primary and secondary brain injuries is crucial for patients, their families, and their lawyers as they navigate the stormy waters of recovery.

I hope this article helps in your understanding of what a secondary brain injury is. If you have any further questions, feel free to reach out. Remember, if you or a loved one has suffered a traumatic brain injury, immediate medical attention is critical.

Classification: Primary and Secondary Brain Injuries

Primary Injuries

Closed brain injuries

Primary injuries occur at the time of the trauma. They are an immediate result of the external mechanical force to the brain. Primary injuries can be open or closed. Open head injuries occur when the skull is fractured, exposing the brain to the environment. Closed brain injuries, on the other hand, involve damage to the brain inside an intact skull.

There are various forms of primary injuries including:

  • Concussion: This is a common type of traumatic brain injury caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull.

  • Contusion: This is a bruise (bleeding) on the brain caused by a forceful impact to the head.

  • Diffuse axonal injury: This occurs when the brain moves back and forth in the skull as a result of rapid forward or backward movement – often seen in car accidents.

  • Skull fracture: A break in one or more of the eight bones that form the cranial portion of the skull usually caused by a blow to the head.

Secondary Injuries

secondary injuries

As we’ve previously discussed, secondary injuries develop over time after the initial trauma. Secondary brain injuries can arise as a direct or indirect result of the primary injury and can significantly exacerbate the effects of the initial trauma. This may include:

  • Intracranial Hemorrhage: Also known as a brain bleed, this condition can lead to a subdural hematoma, where blood collects on the brain’s surface beneath the skull. It can also result in cerebral edema or brain swelling.

  • Hypoxic-Ischemic Injury: This type of injury occurs when the brain does not receive enough oxygen. Insufficient blood flow can lead to the death of brain cells.

Understanding the Spectrum: From Mild to Profound Injury

Brain injuries can range from mild to profound. Mild injuries may result in temporary confusion and headaches, while profound injuries can lead to extended periods of unconsciousness, memory loss, or even permanent disability. This spectrum underscores the serious nature of brain injury, making rapid response and treatment in the emergency department crucial.

Shaken Baby Syndrome: A Tragic Form of TBI

One type of traumatic brain injury worth mentioning is Shaken Baby Syndrome (also called Shaken Impact Syndrome), a serious brain injury resulting from forcefully shaking an infant or toddler. This violent act can lead to a spectrum of injuries from primary damage due to the mechanical injury, and secondary injuries due to lack of oxygen and blood flow to the brain.

By reading this article, you can gain a deeper understanding of “What is shaken baby syndrome?“.

Moving Towards Recovery: Rehabilitation

Rehabilitation for traumatic brain injury patients

Rehabilitation for traumatic brain injury patients is critical. Following the initial trauma, TBI patients may require extensive care to regain physical and cognitive abilities. This may involve occupational therapy, physical therapy, and speech and language therapy.

Motor response, verbal response, and other cognitive functions are often assessed using tools like the Glasgow Coma Scale to gauge the extent of the injury and the effectiveness of rehabilitation.

Ongoing Research: Animal Models & More

Research into traumatic brain injuries, including the use of animal models, is ongoing. These studies aim to provide a better understanding of the injury mechanisms and potential treatments for both primary and secondary brain injuries. Insights from these studies can guide clinical practices and hopefully lead to better outcomes for TBI patients in the future.


Primary and secondary brain injuries, caused by events such as head trauma, falls, and car accidents, can lead to serious and long-lasting complications. A comprehensive understanding of these injuries is essential for prompt diagnosis and effective treatment. From the emergency department to rehabilitation, healthcare professionals play a vital role in mitigating the effects of these injuries and improving the quality of life for TBI patients.

Similar Posts