What Is a Diffuse Axonal Injury—and How Is It Proven in Court?
A diffuse axonal injury (DAI) is one of the most severe and devastating types of traumatic brain injuries. It often occurs in high-impact accidents like car crashes, truck collisions, and serious falls. While a DAI may not involve visible bleeding or swelling, it can cause widespread and long-term damage to the brain’s structure and function. Worse yet, these injuries are notoriously difficult to detect using traditional imaging tools like CT scans—making them challenging to prove, both medically and legally.
At Kalfayan Merjanian, LLP, we represent clients across California who have suffered catastrophic brain injuries, including DAI, due to the negligence or wrongdoing of others. If you or a loved one has been diagnosed with this condition, here’s what you need to know about how DAIs happen, how they’re diagnosed, and how they are proven in court. For personalized advice tailored to your specific situation, contact our office to speak with an experienced California catastrophic injury attorney.
What Is a Diffuse Axonal Injury?
A diffuse axonal injury occurs when the brain is subjected to rapid acceleration or deceleration—typically during a violent impact or rotation of the head. These forces cause the brain to move within the skull, stretching and tearing the long connecting nerve fibers known as axons.
This tearing disrupts communication between different areas of the brain and can lead to loss of consciousness, coma, or long-term cognitive impairment. Unlike a localized brain injury, which is confined to a specific area, a DAI affects multiple areas of the brain, particularly the white matter. This makes the condition both more serious and more complex.
Common causes of diffuse axonal injuries include:
- High-speed motor vehicle accidents (car, truck, motorcycle)
- Pedestrian or bicycle collisions
- Falls from heights
- Sports-related trauma
- Violent assaults or shaken baby syndrome
Depending on the severity, a DAI can result in a variety of symptoms, including confusion, memory loss, personality changes, problems with speech or movement, and persistent vegetative states.
Why Are Diffuse Axonal Injuries So Hard to Diagnose?
One of the most frustrating aspects of a diffuse axonal injury is that traditional imaging tools often fail to detect it. CT scans, commonly used in emergency rooms, may appear normal even when a serious injury has occurred. This is because DAIs typically involve microscopic damage that isn’t visible on standard imaging.
Diagnosis usually relies on:
- MRI scans, particularly advanced techniques like diffusion tensor imaging (DTI), which can reveal white matter abnormalities and axonal disruption.
- Neurological assessments by specialists to evaluate changes in cognition, motor skills, and behavior.
- Long-term observation of symptoms and functional impairments, often by a team of doctors, neuropsychologists, and rehabilitation therapists.
Due to the complexity and subtlety of the injury, DAIs are sometimes misdiagnosed—or dismissed entirely—as post-concussion syndrome or psychological distress. That’s why having skilled medical and legal professionals involved early is crucial.
Proving a Diffuse Axonal Injury in Court
Proving a DAI in court requires more than just a diagnosis—it requires a comprehensive legal and medical strategy to connect the injury to the incident and demonstrate the extent of its impact on the victim’s life. At Kalfayan Merjanian, LLP, we draw on a network of experts to build compelling cases on behalf of TBI victims.
Here are some key components to proving a DAI in court:
1. Expert Medical Testimony
Because DAIs often lack obvious visual confirmation on imaging, expert testimony is essential. Neurologists, neuropsychologists, and radiologists with experience in brain trauma can help explain how the injury occurred, why it may not show up on a CT scan, and what the long-term consequences are. Testimony may include interpretation of MRIs, cognitive testing, and explanations of the medical literature on DAI.
2. Advanced Neuroimaging
In some cases, advanced MRI techniques such as DTI or functional MRI (fMRI) can provide critical evidence. These scans can highlight changes in white matter integrity and provide objective proof of axonal damage. This type of evidence can be persuasive to both judges and juries, especially when supported by medical experts.
3. Neuropsychological Evaluation
A comprehensive neuropsychological exam can demonstrate how the injury has impaired a person’s ability to think, remember, focus, or interact with others. This is often the most practical way to measure the real-world impact of the injury and can help quantify damages for pain and suffering, lost earning capacity, and future care needs.
4. Testimony from Family and Friends
Lay witness testimony from people close to the victim can also be powerful. Spouses, siblings, co-workers, and friends can describe the changes they’ve seen in the victim’s personality, mood, memory, and behavior—helping to paint a complete picture of how the injury has affected everyday life.
5. Life Care Planning and Economic Analysis
For severe cases, proving damages may also involve input from a life care planner and an economic expert who can estimate the costs of future medical treatment, long-term care, vocational rehabilitation, and lost lifetime earnings. These projections are critical in obtaining full compensation for TBI victims and their families.
Get the Legal Help You Need After a Diffuse Axonal Injury
If you or a loved one has suffered a diffuse axonal injury due to someone else’s negligence, your recovery may be long and uncertain—but you do not have to face it alone. At Kalfayan Merjanian, LLP, our experienced trial lawyers understand the science behind traumatic brain injuries and the legal strategies necessary to hold responsible parties accountable.
We work with top-tier medical professionals and expert witnesses to thoroughly document the injury and build a strong, persuasive case. Whether the injury occurred in a motor vehicle accident, a fall, or another traumatic event, our team is here to help our clients navigate the legal process and secure the justice they deserve.
Contact Kalfayan Merjanian, LLP Today
For a free, confidential consultation with an experienced California brain injury attorney, contact Kalfayan Merjanian, LLP today.
