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Understanding the four types of traumatic brain injuries

The brain is an amazing organ that controls essential functions like breathing, motor skills that help us move around, emotions that color our experiences, memories that help us learn and creativity that helps us problem-solve. It should not be a surprise that an organ that performs so many functions can also cause an incredible amount of suffering when it is damaged.

Traumatic brain injuries (TBIs) are one class of injuries that can happen to the brain. Typically, TBIs are caused by some sort of external force. Different kinds of force, such as a blow, shake or rotation, can cause different types of TBIs. Four different types of TBI include a concussion, contusion, diffuse axonal and penetration.


Many people do not realize that a concussion is a variety of TBI. It can be caused by a blow to the head, violent shaking of the head, whiplash or a gunshot. The symptoms of a concussion, which may include a headache, confusion or nausea, can be temporary or permanent depending on the severity of the injury.


A contusion, which is a bruise or bleeding of the brain, can also be caused by direct impact to the head. Contusions may require surgery to remove them. Occasionally, a force is strong enough to cause a contusion on the side of impact as well as the opposite side. When contusions happen on both sides of the brain it is called a coup-contrecoup.

Diffuse axonal

A diffuse axonal is when nerve tissues in the brain tear as a result of shaking or forceful rotation of the head. This type of injury is possible after a baby has been violently shaken or after someone has experienced a car accident. The torn nerve tissues can release chemicals, which can cause additional injury. Symptoms can vary depending on the areas that were affected, and the damage can be permanent.


This type of brain injury is caused when a sharp object forces fragments of the object –along with hair, skin and bone – into the brain. The penetration injury can be accompanied by shearing, stretching and rupture of brain tissue. Many penetration injuries result in death.

If someone you know has received a head injury in a car accident, slip and fall or assault, it is a good idea to help that person get to a doctor right away. Because we rely so heavily on our brains to perform even basic tasks, brain injuries of all types can be dangerous if not treated properly.

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