Closed Head Injury
A closed head injury is trauma]]> to the head that causes the skull and brain to knock or shake. Internal damage can occur to the:
- Blood vessels
- Layers between the skull and scalp
This damage can cause swelling or pressure on the brain. The injury can be throughout the brain and skull. Or, it can be in one region.
Often times, the head injury is minor. But, it can serious and life threatening. It requires care from a doctor.
Closed head injuries are caused by trauma to the head. This is often due to:
- Accidents (eg, automobile, work-related, sports-related)
These factors increase your chance of developing a closed head injury:
- Being of advanced age (due to greater risk of falls)
- Being of relatively young age (higher risk of motor vehicle accidents)
- Playing high-impact sports (especially boxing, basketball, baseball, football)
- Being physically abused (eg, shaken baby syndrome]]>)
- Having a previous head injury or ]]>concussion]]>
- ]]>Abusing alcohol]]> or ]]>drugs]]>
Tell your doctor if you have any of these risk factors.
Symptoms can appear right away or the days and weeks following the injury.
If you have any of these symptoms do not assume it is due to closed head injury. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Symptoms of a concussion:
- Confusion, loss of memory about the accident
- Low-grade headache or neck pain
- Having trouble remembering, paying attention, organizing, making decisions
- Slowness in thinking, acting, speaking, or reading
- Feeling fatigued or tired
- Change in sleeping pattern (eg, sleeping longer, having trouble sleeping)
- Loss of balance, feeling light-headed or dizzy
- Increased sensitivity to sounds, light, distractions
- Blurred vision or eyes that tire easily
- Loss of sense of taste or smell
- Ringing in the ears
- Feeling sad, anxious, or listless, lacking motivation
- Becoming easily irritated or angry for little or no reason
- Symptoms of a skull fracture]]> or focal brain injury:
- Leaking cerebrospinal fluid
- Blood in the ears
- Weakness or numbness of the limbs
- Swelling, tenderness at injury site
- ]]>Hearing loss]]>
- Progressive worsening of cognition or level of alertness
Your doctor will ask about your symptoms and medical history. He will also do a physical exam. You may be referred to a neurologist for special testing.
Tests may include:
- CT scan]]>—a type of x-ray that uses a computer to make pictures of structures inside the head
- ]]>MRI scan]]>—a test that uses magnetic waves to make pictures of structures inside the head
- Blood tests
- Neurological examination
- Neuropsychological tests
- ]]>EEG]]> (electroencephalogram)—a noninvasive test used to evaluate brain function
If you are diagnosed as a closed head injury, follow your doctor's instructions.
Talk with your doctor about the best treatment plan for you. Treatment will depend on:
- Your symptoms
- Location and severity of the injury
Treatment options include the following:
Monitoring and Observation
For minor injury with little or no symptoms, your doctor may advise that you watch for symptoms to develop in the days and weeks that follow.
If you have a concussion, a responsible adult will need to observe you. You may also need to limit drug and alcohol use.
You may need more testing done. These tests assess how your brain functions. The results can help your doctor determine:
- How you are recovering
- Whether you are ready to return to high-impact activities
Your doctor may prescribe medication to:
- Reduce pressure inside the head or brain swelling
- Prevent seizures (given in some cases)
- Reduce pain
This usually involves making “burr holes” in the scalp and skull and draining the clotting blood. Sometimes a section of the skull is removed to relieve pressure. This is called a craniotomy.
To help reduce your chances of getting a closed head injury, take the following steps:
- Don't drink and drive.
- Avoid use of sedating drugs, especially when driving or using heavy equipment.
- Limit your alcohol intake to a moderate level. This means:
- Two or fewer drinks per day for men
- One or fewer drinks per day for women
- Obey speed limits and other driving laws.
- Always use child safety seats, seatbelts, and shoulder harnesses in cars. Also, learn how to safely use air bags.
- Wear a helmet when:
- Riding a bike or motorcycle
- Playing a contact sport (eg, football, soccer, hockey)
- Using skates, scooters, and skateboards
- Catching, batting, or running bases in baseball or softball
- Riding a horse
- Skiing or snowboarding
- Reduce the risk of fall or injury. Safeguard your home and workplace.
- Make sure your child's play area is soft and free of rocks, holes, and debris.
- Have regular blood tests if you are taking blood thinning medicine.
American Academy of Neurology
Brain Injury Association of America
The Brain Injury Association of Canada
Ontario Brain Injury Association
American Academy of Pediatrics. The management of minor closed head injuries in children. Pediatrics. 1999;104:1407-1415.
Closed head injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 29, 2009. Accessed May 19, 2009.
Kellicker P. Skull and facial fracture. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated December 31, 2008. Accessed May 19, 2009.
Smoots E. Concussion. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated February 26, 2009. Accessed May 19, 2009.
Last reviewed June 2009 by ]]>Rimas Lukas, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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