Air Crashes and Brain Injuries

People have two completely different images of air crashes. The most common is the complete catastrophe, fiery wreck, everyone dies. The other is Captain Sully’s, the miracle landing, heroic acts and everyone lives. There are air crashes in between. Years ago, we worked with the Nolan Law Group on one of those in between crashes, a crash like the American Airlines Flight 311, that happened on the runway. That crash was the fated Singapore Air Flight, SQ006.

A bit about our relationship with the Nolan Law Group. I do almost exclusively brain injury work. I got to know Don Nolan in 1994 because his firm also did brain injury work, but since then Don’s focus has shifted to large scale disaster litigation, like the SQ006 crash, where the Nolan Law Group represented more than 30 people, who survived that wreck. The Brain Injury Law Group has been affiliated with the Nolan Law Group for more than ten years, primarily in cases where there has been brain injuries as part of a mass catastrophe.

Now a bit about how brains get injured. There are primarily three ways a brain gets hurt. The first is a blow to the head. A blow transfers energy directly from the skull to the brain, causing injury. The second way a brain gets injured is when a rapid change in direction, acceleration or deceleration, causes the brain to collide with the inside of the skull. Both of these first two types of injuries will more often be associated with bleeds or hemorrhages, events which will increase the intracranial pressure in the brain. In intracranial pressure event injuries brain surgery may be needed to avoid a fatal increase in pressure. See http://subtlebraininjury.com/biomechanics1.html

The third way a brain can get injured is through a stretching and tearing of the communication fibers of the brain, the axons. For a detailed explanation of the structure of brain tissue, see http://subtlebraininjury.com/neuron.html Axons are the long thin part of a neuron, which as they cross several layers of brain tissue, are subject to injury when the brain is twisted internally as a result of significant acceleration/deceleration. Such an injury is called a Diffuse Axonal Injury. See http://subtlebraininjury.com/shear1.html

People understand that when you are in a car wreck, the body is subjected to all of these forces. We also now understand that seatbelts and airbags are designed to protect us from such forces, because they restrain the head from hitting the windshield and cushion the body, so that the acceleration/deceleration forces are less.

Airplanes don’t have airbags and the lap belt only seatbelts would no longer be allowed in a car. One thing that struck me about the American Flight 311 complaints of passengers was all the back pain. The reason the lap belt only seatbelt is not allowed in cars is that it causes back injury. The other thing wrong with a lap belt only mechanism is that it may magnify the acceleration/deceleration of the neck and head.

All three types of mechanism of brain injury could have occurred in Flight 311. Near where the spots in the jet where it broke apart, there is a high likelihood of someone hitting their head. The rapid deceleration when the jet suddenly stopped just short of the sea, comes not only the risk of a collision between the brain and the inside of the skull, but also the risk of the internal twisting of the brain that can cause Diffuse Axonal Injury.

To the survivors of Flight 311 and their families and loved ones, keep an eye for the symptoms of concussion – confusion, amnesia, dizziness, headache. Follow-up continuously with the doctor until the symptoms clear.