Open vs. Closed TBI: Legal Rights for NYC Victims

A traumatic brain injury (TBI) is not “just a head injury.” It can affect memory, concentration, mood, speech, balance, and your ability to work or live independently. Some symptoms resolve. Others can last for months or become permanent. In the most severe cases, a TBI can be fatal.

If you or someone you love suffered a brain injury in New York City after a car accident, fall, construction accident, assault, or another preventable event, you deserve clear answers and real support. Greenstein & Pittari, LLP represents traumatic brain injury victims across Manhattan, Brooklyn, Queens, the Bronx, and Staten Island with rigorous legal advocacy and compassionate client care.

Call 1-800-VICTIM2 (1-800-842-8462) for a free, confidential consultation. The call is free. The consultation is free. You do not pay us unless we are successful. That is our Fee Guarantee.

Understanding Open vs. Closed Traumatic Brain Injuries

Doctors classify TBIs as open or closed based on whether the skull was penetrated. This distinction helps medical providers assess risks such as infection, swelling, bleeding, and long-term disability. It also matters in a New York City personal injury claim because it helps determine what medical evidence and expert testimony may be needed.

A closed TBI can be just as severe, and sometimes more dangerous, than an open TBI because internal bleeding or swelling may not be obvious right away. Symptoms can appear immediately or develop hours, days, or even weeks later.

What Is a Traumatic Brain Injury?

A traumatic brain injury occurs when an external force disrupts normal brain function. TBIs range from mild concussions to catastrophic injuries that cause permanent disability, coma, or death. Even a “mild” TBI can lead to lasting cognitive, emotional, and physical symptoms.

In NYC injury cases, TBIs often happen in:

• Car, truck, taxi, rideshare, and bus accidents
• Pedestrian and bicycle crashes
• Slip and fall and stairway accidents
• Construction and workplace incidents, including struck-by accidents and falls from height
• Assaults and negligent security incidents

What Is an Open TBI?

An open TBI, also called a penetrating brain injury, happens when an object fractures the skull and enters the brain tissue. These injuries are typically severe and require emergency treatment.

Common causes of open TBIs include:

• Gunshot or projectile injuries
• Severe motor vehicle collisions involving metal, glass, or debris
• Major falls or blunt-force trauma that causes a skull fracture with penetration
• Fireworks or other high-force accidents

Important note: A scalp cut or surface bleeding alone does not necessarily mean the injury is “open.” The defining feature is penetration of the skull and or a breach of the protective membranes surrounding the brain.

Why open TBIs are medically complex

Open TBIs often cause direct, localized damage at the penetration site, but complications can extend far beyond that area, including:

• Significant bleeding and swelling
• Increased intracranial pressure
• Infection risks, including meningitis or brain abscess, because protective barriers are compromised

Typical treatment for an open TBI

Treatment often requires emergency intervention, such as:

• Surgery to remove foreign objects and damaged tissue
• Repairing skull fractures and protective membranes
• Procedures to relieve pressure inside the skull

Even with excellent care, many survivors face long-term impairment and may need extensive rehabilitation and ongoing support.

What Is a Closed TBI?

A closed TBI occurs when the skull remains intact, but a blow or other force causes the brain to move within the skull. That movement can bruise the brain, tear nerve fibers, or cause bleeding and swelling.

Common causes of closed TBIs include:

• Falls, including sidewalk hazards, stairway falls, and workplace falls
• Car, truck, motorcycle, bicycle, and pedestrian crashes
• Sports and recreational impacts
• Physical assaults
• Whiplash-type forces

How close TBIs cause damage

Even without a skull fracture, the brain can be injured when it:

• Slams against the inside of the skull
• Rebounds and causes injury at opposite points, often called a coup-contrecoup injury
• Twists or rotates rapidly, which can tear nerve fibers
• Swells inside the rigid skull, raising intracranial pressure

Types of closed traumatic brain injuries

Closed TBIs can include:

• Concussion: The most common TBI. Symptoms can include headache, dizziness, confusion, nausea, memory problems, and concentration issues.
• Contusion: A bruise or bleeding on the brain that can increase swelling and pressure. Coup-contrecoup injuries can cause damage at the impact site and the opposite side.
• Hematoma: Blood collecting inside the skull, which may require surgery.
• Diffuse Axonal Injury (DAI): Tearing of brain fibers from rapid movement or rotation. Severe cases can cause prolonged unconsciousness, coma, or permanent disability.

Why closed TBIs can be especially dangerous

Some people feel “mostly fine” at first, only to worsen later as swelling or bleeding increases. Because closed head injuries may not be visible, they can be missed without timely medical evaluation and imaging.

Key Differences Between Open and Closed TBI

The simplest distinction is whether the skull is breached:

• Penetration: Open TBI involves skull fracture and penetration. Closed TBI does not.
• Infection risk: Higher in open TBI because brain tissue and protective layers may be exposed.
• Visibility: Open injuries are often apparent. Closed injuries may be subtle and more complex to diagnose.
• Severity: Open TBIs are almost always severe. Closed TBIs range from mild to catastrophic.
• Complications: Both can involve bleeding, swelling, permanent disability, or death.

Both open and closed TBIs can support a New York City personal injury claim when negligence is involved.

Warning Signs After a Head Injury in New York City

Seek medical care immediately after a head impact or violent jolt, mainly if any of the following occur:

• Headache that persists or worsens
• Dizziness, balance problems, nausea, or vomiting
• Confusion, memory problems, slowed thinking, or difficulty concentrating
• Vision or hearing changes, including ringing in the ears
• Unusual fatigue, drowsiness, or difficulty waking up
• Weakness or numbness, especially on one side of the body
• Mood or personality changes, including anxiety, depression, or sudden irritability
• Any loss of consciousness, even briefly
• Symptoms that worsen over hours or days

If symptoms worsen, treat it as a medical emergency.

How TBIs Cause Lasting Damage

Brain trauma can involve multiple overlapping mechanisms:

• Bruising and bleeding from impact
• Cellular-level tearing when axons stretch and rupture
• Swelling that raises intracranial pressure because the skull limits space for expansion

These mechanisms help explain why TBIs often require careful monitoring, prolonged treatment, and rehabilitation.

When Negligence Causes a TBI in NYC, You May Have a Case

If your brain injury occurred because someone failed to act safely, you may be entitled to compensation. Potentially responsible parties can include negligent drivers, property owners, employers, contractors, security companies, or other entities.

Common NYC TBI cases we handle include:

• Motor vehicle accidents, including rideshare, taxi, bus, and commercial truck crashes
• Construction and worksite accidents, including falls and struck-by incidents
• Premises liability cases, including unsafe stairs, broken handrails, poor lighting, and negligent security
• Pedestrian and bicycle crashes
• Assault-related injuries where inadequate security contributed

A key advantage of contacting a brain injury lawyer early is the preservation of evidence. Surveillance footage, incident reports, witness accounts, and scene conditions can disappear quickly.

What Compensation Can Include in a New York City TBI Claim

A traumatic brain injury can create immediate and long-term financial strain. Depending on the facts of your case, compensation may include:

Economic damages:

• Emergency care, hospitalization, surgery, medications
• Follow-up treatment and specialist care
• Physical therapy, occupational therapy, speech therapy, and cognitive rehabilitation
• Lost wages and reduced earning capacity
• Long-term care, home health aides, and life-care needs
• Necessary home or vehicle modifications

Non-economic damages:

• Pain and suffering
• Emotional distress
• Loss of enjoyment of life
• Loss of consortium or companionship in appropriate cases

Our goal is to document the full impact of the injury, including future needs, not just the bills you have today.

Why Insurance Companies Fight TBI Claims

Traumatic brain injury cases are medically and legally complex. Insurance companies often dispute:

• Causation, claiming symptoms are unrelated or pre-existing
• Severity, arguing a concussion is “minor” or has resolved
• Damages, minimizing the effect on work, relationships, and daily life

A strong claim typically includes consistent medical documentation, imaging when appropriate, specialist evaluations, symptom tracking, and evidence of how the injury changed your life.

How Greenstein & Pittari, LLP Can Help

A skilled NYC brain injury attorney can:

• Investigate the accident and identify all responsible parties
• Preserve critical evidence quickly
• Work with medical professionals and qualified experts to explain your diagnosis and long-term prognosis
• Calculate current and future losses, including life-care needs and diminished earning capacity
• Negotiate with insurance companies and refuse low settlements
• Prepare the case for trial when necessary

If you are dealing with a traumatic brain injury, you should not have to manage insurance pressure while trying to heal.

Free Consultation With Greenstein & Pittari, LLP

Call 1-800-VICTIM2 (1-800-842-8462) to schedule a free, confidential consultation.

We represent brain injury victims throughout New York City and across New York, with seven convenient office locations in Harlem, the Bronx, Brooklyn, Queens, Staten Island, Yonkers, and Nassau County.

You pay nothing unless we are successful. That is our Fee Guarantee.

Why Choose Greenstein & Pittari?

• Local Harlem office for convenience and trust
• Seven convenient locations throughout New York: Harlem, Bronx, Brooklyn, Queens, Staten Island, Yonkers, and Nassau County
• No fee unless we win your case, Our Fee Guarantee
• Bilingual services available
• Hundreds of positive client reviews and testimonials
• We handle the insurance companies so you can focus on healing
• Top-rated, award-winning lawyers, including recognition in Best Lawyers and Super Lawyers

Our motto is “Don’t Be a Victim Twice.”

FAQ: Open vs. Closed Traumatic Brain Injury in New York City

What is the main difference between an open and closed TBI?
An open TBI involves a skull fracture and penetration of brain tissue. A closed TBI occurs when the skull remains intact, but the brain is injured by impact or movement inside the skull.

Can a closed TBI be worse than an open TBI?
Yes. Closed TBIs can be extremely severe, especially when internal bleeding, swelling, or diffuse axonal injury is involved.

Are open TBIs always severe?
Open TBIs are typically severe because they involve penetration of the skull and increased risks of bleeding and infection.

Can TBI symptoms appear days or weeks later?
Yes. Symptoms can be delayed. Swelling or bleeding can worsen over time, which is why medical evaluation and follow-up matter.

Are concussions considered TBIs?
Yes. A concussion is a form of traumatic brain injury and should be taken seriously.

What are the warning signs after a head injury that require emergency care?
Worsening headache, repeated vomiting, seizures, weakness or numbness, slurred speech, confusion, difficulty waking up, and any symptom that worsens over time.

What NYC accidents commonly cause traumatic brain injuries?
Car accidents, pedestrian and bicycle crashes, falls, construction accidents, workplace incidents, assaults, and negligent security cases are common causes.

How do doctors diagnose a traumatic brain injury?
Doctors may perform neurological exams and order imaging such as CT scans or MRIs. Additional testing and specialist evaluation may be needed if symptoms persist.

Can I file a personal injury claim for a concussion in New York City?
Often, yes, if negligence caused the accident and medical evidence links the concussion and symptoms to the incident.

Why do insurance companies dispute closed head injury claims?
Because symptoms may be delayed or difficult to measure, insurers often argue the injury is minor, unrelated, or resolved.

How long do I have to file a TBI lawsuit in New York?
Deadlines vary by defendant and circumstances and may be shorter when a public entity is involved. Speak with a lawyer as soon as possible to protect your rights.

What should I do after a head injury in NYC?
Get medical care immediately, follow treatment recommendations, document symptoms, keep all records and bills, and speak with a lawyer before giving recorded statements or accepting any settlement.

Do I need a lawyer for an open or closed TBI case?
Brain injury claims are complex and often heavily contested. An experienced NYC TBI lawyer can protect you from insurance tactics and fight for compensation that reflects long-term needs.