Photo: Brain Injury 101

Brain Injury 101

Brain injuries caused by intimate partner violence (IPV) are known as acquired brain injuries (ABIs) – brain injuries that occur after birth.1 Two types of ABIs are most common among women survivors of IPV: traumatic brain injury (TBI), and brain injury by strangulation.

What is TBI?

The formal definition of TBI is “an alteration in brain function, or other evidence of brain pathology caused by an external force”.2 In other words, TBI occurs following a hit or other impact to the head, neck, face, or body,3 that injures the brain and disrupts its normal functioning.


Strangulation is the most dangerous form of IPV.4 When someone is strangled, blood flow to their head is reduced, and their brain is deprived of oxygen and nutrients. This creates a toxic environment for brain cells.5,6 Without oxygen, it takes just 15 seconds for a person to lose consciousness. After four minutes, a brain injury is likely to occur. If strangulation lasts longer, a person can enter a coma, experience seizures, and potentially die.7

The technical definition of a brain injury caused by strangulation is hypoxic-ischemic brain injury, or HIBI.

How does brain injury occur in IPV?


  • Bump, blow, or jolt to the head, neck, or face
  • Penetration of the skull (e.g., by shooting, stabbing)
  • Forceful and repeated shaking


  • Strangulation
  • Suffocation
  • Choking
  • Near drowning
  • Low blood pressure resulting from blood loss


1Ontario Neurotrauma Foundation, “Acquired Brain Injury,” Ontario Neurotrauma Foundation. [Online]. Available:

2D. K. Menon, K. Schwab, D. W. Wright, A. I. Maas, Demographics, I. Clinical Assessment Working Group of the, I. Interagency Initiative toward Common Data Elements for Research on Traumatic Brain, and H. Psychological, “Position statement: definition of traumatic brain injury,” Arch Phys Med Rehabil, vol. 91, no. 11, pp. 1637–1640, 2010.

3P. McCrory, W. Meeuwisse, J. Dvorak, M. Aubry, J. Bailes, S. Broglio, R. C. Cantu, D. Cassidy, R. J. Echemendia, R. J. Castellani, G. A. Davis, R. Ellenbogen, C. Emery, L. Engebretsen, N. Feddermann-Demont, C. C. Giza, K. M. Guskiewicz, S. Herring, G. L. Iverson, K. M. Johnston, J. Kissick, J. Kutcher, J. J. Leddy, D. Maddocks, M. Makdissi, G. T. Manley, M. McCrea, W. P. Meehan, S. Nagahiro, J. Patricios, M. Putukian, K. J. Schneider, A. Sills, C. H. Tator, M. Turner, and P. E. Vos, “Consensus statement on concussion in sport - the 5th international conference on concussion in sport held in Berlin, October 2016,” Br. J. Sports Med., no. October 2016, p. bjsports-2017-097699, 2017.

4N. Glass, K. Laughon, J. Campbell, C. R. Block, G. Hanson, P. W. Sharps, and E. Taliaferro, “Non-fatal Strangulation is an Important Risk Factor for Homicide of Women,” J. Emerg. Med., vol. 35, no. 3, pp. 329–335, 2008.

5R. S. Howard, P. A. Holmes, and M. A. Koutroumanidis, “Hypoxic-ischaemic brain injury,” Practical Neurology, vol. 11, no. 1. pp. 4–18, 2011.

6K. M. Busl and D. M. Greer, “Hypoxic-ischemic brain injury: Pathophysiology, neuropathology and mechanisms,” NeuroRehabilitation, vol. 26, no. 1. pp. 5–13, 2010.

7Headway: The Brain Injury Association and S. White, “Factsheet: Hypoxic Brain Injury,” Headway: The Brain Injury, 2018. [Online]. Available: for Disease Control and Prevention, “Basic Information about Traumatic Brain Injury and Concussion,” Centers for Disease Control and Prevention, 2016. [Online]. Available: