Every year, at least two million people experience brain injuries. But not all brain injuries are the same. Some are relatively minor, producing only moderate symptoms. Others appear minor, only to produce significant symptoms later. And still others permanently change your life.
A closed brain injury, sometimes called a closed head injury, is a brain injury that does not open up the brain or skull. Instead, the injury comes in the form of a sharp blow that rattles or otherwise traumatizes the brain.
A concussion is a classic example of a closed brain injury. Knowing that your head injury is a closed injury won't tell you much about your prognosis, since even closed injuries can be quite severe. But understanding what exactly a closed injury is can help you ask intelligent questions while planning for the future.
What is a Closed Head Injury?
Closed head injuries are the most common type of brain injury, accounting for about 75% of the estimated two million brain injuries that occur annually. When a head injury is closed, nothing directly touches the brain. Instead, the injury comes from the brain rattling in the skull. If the head is hit with sufficient force, the brain may even be bruised by the skull itself.
Closed head injuries are typically less severe than open head injuries, since nothing directly touches or punctures the brain. However, a sufficiently serious closed head injury can be fatal, and symptoms are not always immediate. The most common types of closed head injuries include:
- Diffuse axonal injury: This injury occurs when the neurons of the brain are injured, often due to shaking or whiplash. Common in car accident victims, a diffuse axonal injury can lead to permanent brain damage.
- Concussion: Concussions usually result in only temporary disruption of brain function, but repeated concussions can cause concussion syndromes that produce lasting damage. Moreover, if a concussion is not promptly treated and swelling continues, the concussion survivor can die.
- Intracrainal hematoma: This occurs when a ruptured blood vessel results in a pool of blood either around the brain or in between the brain and skull. It can cause intense pressure on the brain that may be fatal or permanently damaging if not promptly treated. Because an intracranial hematoma is often caused by another type of injury, it's critically important to discern the cause of the injury.
- Cerebral contusion: Similar to a concussion, a cerebral contusion is a bruise on the brain resulting from trauma. This localized injury typically only disrupts function in the region of the brain affected, but a severe contusion can be life-threatening.
Short-Term Symptoms of a Closed Head Injury
The most significant and obvious symptom of a closed head injury is a sudden blow to the head or neck. Because some closed head injury survivors do not show any immediate symptoms, any blow to the head—particularly one that results in loss of consciousness or resulting from a car accident—warrants prompt medical attention.
Even if a head injury seems minor or you cannot confirm that one occurred, the following symptoms are common after a closed head injury, and demand prompt medical care:
- Changes in consciousness, including loss of consciousness, fainting, unexplained sleepiness, or drowsiness.
- Changes in mood, behavior, or personality.
- Changes in the eyes, particularly the eyes rolling back in the head.
- Swelling at the site of a suspected brain injury, especially if the swelling is significant or is surrounded by bruising.
- Headaches and dizziness
- Dilated pupils.
- Difficulty concentrating or confusion.
- Inability to remember what happened immediately before the head injury.
- Difficulty breathing, or changes in the rate of breathing.
- Any fluid leaking from the nose, eyes, or ears. This could be leaking cerebrospinal fluid.
- Difficulties with language or speech.
- Changes in vision, especially blurred vision.
- Vomiting and nausea.
Long-Term Symptoms of a Closed Head Injury
The long-term symptoms of a closed head injury vary greatly from person to person, and are dependent upon a number of factors, including:
- Overall health: People in poor health are more vulnerable to serious head injuries. A head injury can also be more dangerous if you have a previous history of head injuries or an active infection.
- Prompt medical treatment: The prognosis is best if you receive prompt medical treatment at a facility skilled at treating head injuries.
- Ongoing physical therapy and rehabilitation: You may need a range of treatments, and consistently engaging in these treatments is your best option for a rapid recovery.
- The severity of the injury, as well as its location.
Because the brain is your body's command center, virtually every bodily function can be affected by a closed head injury. Emotional, psychological, and behavioral changes are common, as are alterations in cognition and intelligence. Some people suffer anger issues or impulse control problems after experiencing a cosed head injury. Others struggle with fine motor skills, memory, personal relationships, and basic functions such as reading and writing.
Many closed head injury survivors who receive prompt medical treatment will suffer no lasting damage. If, however, you have recently suffered a closed head injury and experience new or worsening symptoms, contact your physician immediately.
Treatment for a Closed Head Injury
Treatment for a closed head injury begins with addressing the immediate aftermath of the injury. Your doctor may need to stabilize you, particularly if other injuries accompany the closed head injury. Thereafter, your doctor will likely perform brain imaging scans to determine the location and scope of the injury. From there, he or she will develop a comprehensive treatment plan that may include:
- Careful observation, particularly in the 24 hours following the injury.
- Antibiotics to prevent infection, and medications to reduce or prevent brain swelling.
- Physical therapy to help you regain physical functioning.
- Speech therapy if your speech has been altered by the injury.
- Exercise therapy.
- Occupational therapy if your ability to function in daily life is undermined by the injury.
- Education about brain injuries.
- Psychotherapy to help you cope with the emotional aftermath of a brain injury.
- Medications to help you manage your symptoms, particularly if you experience psychiatric symptoms such as hallucinations, depression, or anger.