Falls Are One of the Leading Causes of Brain Injury

We tend to picture brain injuries happening in high-speed car crashes, contact sports, and falls from significant heights. The reality is considerably more ordinary. A slip and fall on a wet floor, a misstep off a curb, a stumble on an uneven sidewalk. Falls account for nearly half of all traumatic brain injury hospitalizations in the United States, making them the single largest cause ahead of motor vehicle crashes.

Falling might sound minor. But a sudden drop onto a hard surface transfers enormous force to the skull, and the brain inside it doesn’t need to travel far to sustain serious damage. Some of the most consequential brain injuries seen in emergency rooms every year came from falls that happened at ground level. Here is what actually happens when a fall injures the brain, why these injuries are so often missed, and what steps matter most in the hours and days that follow.

Why do falls cause such serious brain injuries?

A fall might look minor from the outside, but the forces involved can cause serious neurological damage in more than one way:

• Coup-contrecoup injury: When the head strikes a hard surface, the brain continues moving inside the cranial cavity after the skull stops, striking one side of the skull on impact and, in some cases, rebounding to strike the opposite side. A single fall can cause damage in two separate locations simultaneously, and the shorter the stopping distance, the greater the concentrated force. Concrete and tile are particularly unforgiving.
• Diffuse axonal injury: When a fall involves any twisting or sideways motion, the brain's different layers rotate at slightly different speeds, stretching and tearing the microscopic nerve fibers connecting them. This injury can cause significant neurological damage while leaving standard imaging completely clear, which is why many fall victims are discharged from the ER with normal scan results and a serious undetected injury.
• Compounded risk in older adults: Cerebrospinal fluid volume decreases with age, reducing the brain's natural cushioning. Bone density decreases, lowering the impact threshold for a skull fracture. Blood thinners dramatically elevate the risk of intracranial bleeding. Slower reflexes mean less ability to protect the head during the fall itself. A fall that a 35-year-old walks away from can be fatal for a 75-year-old on warfarin.

What types of brain injuries can a fall cause?

The range is broader than most people realize, and the severity is not always apparent at first.

• Concussion: the most common fall-related brain injury and the most frequently minimized. It results from the brain shifting inside the skull on impact and can produce effects ranging from temporary disorientation to persistent cognitive and functional impairment.
• Subdural hematoma: bleeding between the brain and its outer covering, caused by tearing of the bridging veins. Particularly dangerous in older adults, because the bleed can develop slowly over days or weeks after what appeared to be a minor fall, expanding silently until symptoms become severe.
• Epidural hematoma: bleeding between the skull and the brain’s outer covering, typically involving arterial bleeding and often associated with a skull fracture. Characterized by rapid deterioration and a brief period of apparent normalcy before a sudden and serious decline.
• Intracerebral hemorrhage: bleeding directly within brain tissue, which can cause immediate neurological impairment, including paralysis, speech difficulties, and loss of consciousness.
• Diffuse axonal injury: widespread microscopic nerve fiber tearing from rotational forces. Invisible on standard CT and MRI scans but capable of producing lasting cognitive changes, personality shifts, and significant functional deficits.

What symptoms should tell you something is wrong?

Some symptoms call for an immediate 911 call. Don't wait to see if they improve:

• Loss of consciousness, even briefly
• Seizures at any point after the fall
• Repeated vomiting, which can signal dangerous intracranial pressure
• Unequal pupil size, slurred speech, or sudden inability to recognize familiar people or places
• A headache that begins after the fall and progressively worsens rather than improving
• Clear fluid draining from the nose or ears

Other symptoms develop more gradually and are easier to rationalize or overlook. Persistent headaches, dizziness, difficulty concentrating, short-term memory gaps, sensitivity to light or noise, mood changes, and disrupted sleep are all potential signs of a brain injury that emerged after the initial shock cleared. In older adults, these delayed symptoms are especially easy to miss because cognitive changes and fatigue are often attributed to age, medication, or the stress of the fall itself. Subdural hematomas are particularly prone to this delayed pattern, expanding quietly for days before symptoms become impossible to ignore. Any change in baseline cognition, behavior, or function following a fall warrants medical evaluation. Don’t wait for things to get worse.

Who can be held responsible when a fall causes a brain injury?

Not every fall is someone’s fault. But many are. Property owners have a legal duty to maintain reasonably safe conditions for people on their premises. When a dangerous condition causes a fall and a serious injury, the owner may be held liable for the resulting damages. The legal standard in Illinois requires establishing that the property owner knew or should have known about the hazardous condition and failed to address it within a reasonable time. Both actual knowledge and constructive knowledge, meaning the condition existed long enough that the owner should have discovered it, can support a claim.

Common negligence scenarios that lead to fall-related brain injury claims include:

• Wet or slippery floors without adequate warning signs
• Broken, uneven, or raised pavement, flooring, or steps
• Missing or defective handrails on stairs, ramps, or elevated walkways
• Inadequate lighting in stairwells, parking structures, or outdoor walkways
• Ice, snow, or standing water left unaddressed on walkways and building entrances

Nursing homes and assisted living facilities carry a heightened duty of care. Residents known to be at elevated fall risk are entitled to individualized fall prevention plans, adequate supervision during transfers and ambulation, and a physical environment that reduces hazards. When a facility fails on any of these fronts, and a resident suffers a brain injury as a result, that failure is actionable under Illinois law, including under the Illinois Nursing Home Care Act. Falls caused by defective assistive devices, such as walkers or wheelchairs, may also support a separate product liability claim against the manufacturer.

Suffered a brain injury in the Bay Area? Our lawyers are ready to fight for you.

A traumatic brain injury doesn't just affect the person who sustained it; it reshapes everything around them. Medical appointments, missed work, mounting bills, and an insurance company that would rather write a small check and close the file. Clancy & Diaz, LLP exists for exactly this moment. Our Walnut Creek brain injury attorneys know how to investigate fall accidents, build cases around medical evidence, and push back hard against insurance companies who undervalue life-changing injuries.

The consultation is free, and representation is on a contingency fee basis, meaning you pay nothing upfront. We serve clients from offices in Walnut Creek, Antioch, Benicia, Brentwood, and Pittsburg, covering the full Bay Area and beyond. If you or a loved one sustained a brain injury in a fall, don't wait and don't guess at what your case might be worth. Contact us today for your free case evaluation and take the first step toward the compensation you deserve.

"Pete Clancy is a Pro. I am completely happy with Pete and his firm. I had a motorcycle injury case, and he leveraged every angle of my case to produce excellent results. I definitely recommend this firm." - M.T. ⭐⭐⭐⭐⭐