Penetrative TBI involves the penetration of a foreign object through the bones of the skull
Lawyers have learned of a new classification for traumatic brain injury (TBI), known as explosive blast traumatic brain injury (bTBI). Previously, physicians divided TBI into two categories, penetrating traumatic brain injury (pTBI) and closed head traumatic brain injury (cTBI). Blast TBI is similar, but has some aspects that are all its own.
Penetrative TBI involves the penetration of a foreign object through the bones of the skull and into the brain parenchyma. This physically disrupts neurons, glia, and fiber tracts, which is made worse by ischemia and hemorrhage. Victims of this type of injury show signs of impaired consciousness and neurological difficulties associated with the parenchyma injured by the intrusion of the foreign object. An object penetrating at high velocity, like a bullet, will cause a great deal more damage, due to cavitation of brain tissue. There will be a breach in the skull where the object entered, and possibly another at the point of exit. pTBI is often easy to spot.
Closed head traumatic brain injury, is sometimes more difficult to spot. The brain moving inside the skull and deformation of the brain can cause injury to the brain parenchyma, blood vessels, and fiber tracts.
In cases involving bTBI, outside physical forces from detonation cause injury to the head and brain. The forces that cause such injuries are not fully understood. The skull may or may not be breached, which is why patients can have symptoms that look more like cTBI, pTBI, or both, when it is, in fact, neither. Hospitals and doctors who practice in The Bronx and Brooklyn are aware of circumstances like this and looking all the time for answers to the questions presented.