Leading Causes of Traumatic Brain Injury

Falls send more people to the hospital with a traumatic brain injury than motor vehicle crashes, assaults and struck-by injuries combined. They accounted for 49.1 percent of all TBI-related hospitalizations in the United States in 2017, and 47.7 percent in 2016, according to the CDC’s surveillance report. Motor vehicle crashes came second at 24.5 percent and 25.0 percent. Everything else splits what is left.

Those two numbers explain most of what a brain injury lawyer sees. They do not explain all of it. The ranking shifts depending on which patients get counted, and that shift changes who you may have a claim against.

The Ranking Changes Depending On Who Gets Counted

No single figure covers every traumatic brain injury, because most TBIs never reach a hospital bed. The CDC says plainly that its hospitalization and death counts leave out injuries treated only in an emergency department, in urgent care or at a primary care office, along with every injury nobody treats at all. That is why the causes get ranked differently on different websites. Two examples, both from the CDC.

• Counting hospital admissions only (2016 and 2017 data): unintentional falls 47.7 percent and 49.1 percent, motor vehicle crashes 25.0 percent and 24.5 percent.
• Counting emergency department visits, hospitalizations and deaths together (2002 to 2006 data): falls 35.2 percent, motor vehicle traffic 17.3 percent, struck by or against an object 16.5 percent, assault 10 percent.

Same agency. Different denominator. Being struck by or against an object looks like a major cause in the wider count and almost vanishes in the hospital count, where it produced roughly 6,200 admissions in all of 2016. Neither number is wrong. They answer different questions, and a page that quotes one without naming the denominator is telling you less than it seems to.

Deaths rank differently again. Suicide accounted for 33.8 percent of TBI-related deaths in 2016 and 34.7 percent in 2017, ahead of unintentional falls at roughly 28 percent in both years. Motor vehicle traffic produced the largest share of TBI-related deaths in the older 2002 to 2006 count, at 31.8 percent.

The CDC flags one more limit. The mechanism of injury was unknown for 7.8 percent of 2016 TBI hospitalizations and 8.3 percent of 2017 hospitalizations, so every percentage above is an undercount rather than a clean split.

One older figure still turns up almost everywhere. It puts traumatic brain injuries at 1.7 million a year in the United States, of which 275,000 are hospitalized and 52,000 are fatal. That comes from a CDC report published in 2010 using 2002 to 2006 data, so it is not current, and the 2020 hospitalization count is lower. The rest of that report is still worth reading. Nearly 80 percent of those 1.7 million injuries were treated and released from an emergency department without ever being admitted. Hospital statistics describe the minority.

Falls

Falls are the leading cause of traumatic brain injury in the United States, and they lead for the youngest and the oldest people in the country. The CDC recorded approximately 214,110 TBI-related hospitalizations in 2020 and 68,663 TBI-related deaths in 2023. Adults aged 75 and older account for about 32 percent of those hospitalizations and 28 percent of the deaths. Age drives this one.

Older Adults Carry Most Of The Risk

Half of all fall-related TBI hospitalizations in 2016 and 2017 involved someone aged 75 or older. The trend is moving the wrong way. CDC researchers found a 17 percent increase in the rate of fall-related TBI deaths nationally between 2008 and 2017, with the largest increases among people aged 75 and above.

The mechanism is unglamorous. That is part of why these cases get underestimated. A standing-height fall onto a hard floor can produce bleeding between the brain and the skull that takes hours or days to show up, particularly for someone on blood thinners. The person gets up, says they are fine, and goes home. The symptoms to watch for after a fall are often delayed.

Children Fall Differently

Falls caused about half of the traumatic brain injuries among children aged 0 to 14 in the CDC’s 2002 to 2006 count, at 50.2 percent. Being struck by or against an object was second for that age group at 24.8 percent, a much bigger share than it holds among adults. Playgrounds, furniture, stairs, sports equipment. Those do most of it.

When A Fall Is Someone Else’s Responsibility

Not every fall is a claim. California law starts from a general rule in Civil Code section 1714, which makes everyone responsible for injuries caused by a want of ordinary care in managing their property or their person. For a fall on somebody else’s property, that usually turns into a premises liability claim, meaning a claim that the owner or occupier knew about a hazard, or should have known about it, and did not fix it or warn you.

The common ones look like this. A grocery aisle that stays wet with no cone out. A stair rail that was loose long enough for staff to notice. An apartment walkway light that had been reported dark for weeks. A construction site with an unguarded floor opening. What links them is notice and time, which is why the useful evidence is usually maintenance logs and prior complaints rather than photographs of the floor.

Falls on public property work differently and the difference is a deadline. Under Government Code section 835, a city, county or state agency can be liable for injury caused by a dangerous condition of its property, but only if it created the condition or had notice of it in time to do something. Before you can sue, you have to present a written claim to the agency, and Government Code section 911.2 gives you six months from when the claim accrues. Six months, not two years. A broken sidewalk, an unlit public stairwell or a missing manhole cover falls into this category.

Ask early. Our San Diego premises liability lawyers can tell you what evidence still exists after a fall and how long it is likely to last.

Motor Vehicle Crashes

Motor vehicle crashes are the second leading cause of TBI hospitalizations, and in the CDC’s 2002 to 2006 count they produced the largest share of TBI-related deaths at 31.8 percent. Your head need not hit anything. Rapid acceleration and deceleration moves the brain inside the skull on its own.

The San Diego Numbers

California’s Office of Traffic Safety counted 4,861 people killed or injured in San Diego traffic crashes in 2023. That put the city 13th out of the 15 California cities in its population group, where rank 1 is the worst performer and 15 is the best, so San Diego sits toward the better end on total crash victims. Some categories do not look as good.

• Motorcyclists: 349 killed or injured, ranked 4 of 15. Fourth worst in the group.
• Bicyclists: 380 killed or injured, ranked 6 of 15.
• People on foot: 522 killed or injured, ranked 10 of 15.
• Hit and run: 533 fatal and injury collisions, ranked 12 of 15.

Riders, Cyclists And People On Foot

Anyone outside a vehicle absorbs the crash with their body, and a helmet is the only thing between the road and the skull. California requires one for motorcycle riders. Vehicle Code section 27803 makes it unlawful to ride a motorcycle, motor-driven cycle or motorized bicycle in California unless the driver and every passenger is wearing a helmet that meets the state standard, fastened and correctly fitted.

Riders sometimes assume that not wearing one ends the case. It does not. California uses comparative fault, which means a jury assigns a percentage of responsibility to each party and reduces the award accordingly. Not wearing a helmet may reduce what you recover. It does not hand the driver who hit you a free pass. That question comes up in almost every San Diego motorcycle accident case, and in pedestrian cases where someone crossed outside a marked crosswalk.

Struck By Or Against An Object

Being struck by or colliding with an object is the cause with the widest gap between how often it happens and how often it puts someone in hospital. It was 16.5 percent of TBIs in the CDC’s wider 2002 to 2006 count and about 6,200 hospital admissions in 2016. Most get treated and released. That is exactly why they get argued about later.

Three settings produce most of them. Construction and warehouse work, where the object is a falling tool, a swinging load or a piece of equipment. Retail and storage, where badly stacked inventory comes off a shelf. Sport, covered separately for football and repeat-concussion cases.

Workplace cases often run on two tracks. Workers’ compensation covers you regardless of who was at fault, and a separate claim may exist against a contractor, equipment manufacturer or property owner who is not your employer. Those are different claims with different deadlines, and pursuing one does not automatically preserve the other. Our San Diego construction accident lawyers handle both sides of that.

Assaults And Intentional Harm

Assaults produced 10 percent of traumatic brain injuries in the CDC’s 2002 to 2006 count. They fall unevenly. In 2016 the age-adjusted rate of assault-related TBI hospitalization was 8.1 per 100,000 for men and 1.7 for women, more than a fourfold difference.

The person who hit you may be liable. They are also frequently uninsured and often not worth suing. The claim that tends to matter is against whoever created the conditions. A bar that kept serving and kept no security. An apartment complex with broken gate locks and a documented history of break-ins. A parking structure with cameras that were never connected. That is a premises liability claim built on foreseeability, and it stands or falls on what the owner already knew.

Two things are worth separating out honestly. Suicide is the single largest contributor to TBI-related deaths in the CDC data, and it is not a civil liability category. If you are in crisis, call or text 988 for the Suicide and Crisis Lifeline. Second, assault cases involving abuse are handled differently from ordinary premises cases and should be discussed directly rather than assessed from a web page.

The Cause Is The First Thing An Insurer Will Attack

How the injury happened is not background detail in a brain injury claim. It is the fight. Insurers rarely dispute that you hit your head. They dispute that the mechanism was capable of causing the damage you are describing, and mild traumatic brain injuries are where that argument lands hardest, because the CT scan is frequently normal and the symptoms are cognitive rather than visible.

Three things protect the case, and all of them decay with time. Get examined and say you hit your head, even if you feel fine, because a gap between the incident and the first medical record becomes the insurer’s whole argument. Preserve the physical evidence of the mechanism, which means the vehicle before it is repaired, the surveillance footage before it overwrites, the maintenance log before it is purged. Write down what changed, day by day, in your own words. Sleep, memory, temper, light sensitivity, word-finding. Families notice the changes before the injured person does, so ask them to write too.

Brain injury cases turn on that record. Symptoms can surface years after the event, and a contemporaneous account of the first few weeks is what makes a later claim credible.

Deadlines Depend On Who Caused It

California gives you two years. Code of Civil Procedure section 335.1 sets that limit for most personal injury suits, covering an action for assault, battery, or injury to or death of an individual caused by the wrongful act or neglect of another.

One exception catches people out. If a public entity is responsible, a city, a county, a school district, a transit agency or the state, you must first present a written claim to that entity, and Government Code section 911.2 gives you six months from when the cause of action accrues. Miss it and the two-year statute may not save you. Deadlines can also run differently when the injured person is a child or lacked capacity after the injury, which is a question to ask a lawyer about directly rather than assume.

Common Questions About TBI Causes

What is the number one cause of traumatic brain injury?

Falls. They accounted for 47.7 percent of US TBI-related hospitalizations in 2016 and 49.1 percent in 2017, according to CDC surveillance data, which is more than motor vehicle crashes, assaults and struck-by events combined.

Can you get a brain injury without hitting your head?

Yes. A hit to the body that whips the head back and forth can move the brain inside the skull and damage brain cells, which is why the CDC defines a concussion to include injuries caused by a blow to the body rather than the head. Whiplash-type crashes and blast exposure both work this way.

Is a concussion a traumatic brain injury?

Yes. A concussion is a mild traumatic brain injury. The word “mild” describes how the injury presented at the time, not how the rest of your life goes, and the CDC notes that most TBIs each year are mild ones.

Who is responsible for a brain injury caused by a fall?

It depends on where you fell and what the owner knew. On private property, a premises liability claim requires showing the owner or occupier knew about the hazard or should have known and failed to fix it or warn you. Public property is different. A written claim usually has to be presented to the agency within six months.

Can a brain injury be missed on a CT scan?

Often, yes. The National Institute of Neurological Disorders and Stroke notes that currently available and clinically validated imaging technologies cannot always detect damage from mild, concussive injuries. A normal CT scan does not rule out a mild traumatic brain injury, which is why the medical record and the symptom diary matter so much to a claim.

How long do I have to file a brain injury claim in California?

Two years for most personal injury claims under Code of Civil Procedure section 335.1. Six months to present a claim to a public entity under Government Code section 911.2. Different rules can apply to injured children. Check the deadline early, because the shortest one governs.

Talk To A San Diego Brain Injury Lawyer

Gomez Trial Attorneys has recovered more than $1 billion for injured people over 20 years. Past results guarantee nothing. Every claim turns on its own facts.

If you or a family member has a head injury from a fall, a crash, a workplace incident or an assault, we will tell you what we think the cause evidence looks like and what is still recoverable. The consultation is free and there is no fee unless we win. Call 833-GET-GOMEZ, or reach our San Diego office at (619) 237-3490. Hablamos español.

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