An open head injury—sometimes known as an open wound brain injury—can be terrifying to witness. These injuries are often extremely bloody because of the large number of blood vessels that serve the brain. They are often life-threatening, but don't allow yourself to be intimidated by the appearance of an open wound brain injury. Some look much worse than they are, and you cannot judge the danger posed by an injury based on how bloody it is or how painful it looks.
Nevertheless, any open head injury warrants immediate medical attention at a local emergency room, and may require treatment at a facility that specializes in brain and spinal cord injuries. The more quickly you seek treatment, the better the prognosis will be.
By definition, an open head injury fractures the skull, and so is sometimes called a broken skull. Sometimes the skull cracks as a result of a sudden blow. In other cases, an object may puncture the skull. Understanding the wide variety of skull fractures, as well as the way these injuries can affect brain health, can help you better understand your injury, ask your doctor the right questions, and assess your prognosis.
Open head injuries occur when something hits the head forcefully enough to penetrate the skull. A minor bleed on the head—such as from getting punched or hitting your head on a desk corner—does not qualify as an open head injury. Instead, your skull must be penetrated by an object.
Some open head injuries merely penetrate the skull; while these can be life-threatening, they are typically far less dangerous than injuries that also penetrate the brain. When an object makes contact with the brain, permanent brain damage may be the result. Severe bleeding, blood clots, and other life-threatening injuries can also occur, so it's vital to seek emergency medical assistance. Never try to remove an object on your own, or adopt a “wait and see” approach. Even if you feel fine, your life might be in danger.
Most doctors differentiate between four different types of open wound brain injuries. Those include:
Any open wound brain injury is a life-threatening medial emergency. Do not try to treat symptoms at home or adopt a wait and see approach. Instead, go to an emergency room—ideally at a trauma care hospital—immediately. If you're not sure whether you've suffered a skull fracture, some of the immediate symptoms include:
The long-term effects of an open wound brain injury vary greatly from person to person, and depend on factors such as the severity of the injury, the area of the brain injured, overall health, quality of medical care, and quality of follow-up care. For example, a healthy young person who continues with physical therapy has a much better prognosis than an older person in poor health who does not engage in physical therapy. Your doctor can give you the most accurate estimate of your prognosis, but some of the most common long-term effects of an open wound injury include:
Immediate treatment for an open wound brain injury focuses on stopping the bleeding and, if possible, removing the object that caused the wound. Rarely, removal is more dangerous than leaving the object in place, so you should never try to remove a foreign object yourself. Many open wound brain injury survivors require several surgeries to cauterize blood vessels, treat skull fractures, and remove foreign objects.
From there, the recovery process depends on how severe the injury was. Some open wound brain injury survivors heal with little medical intervention; this is especially true of people who suffer only minor linear skull fractures. Other need years of follow up therapy and treatment. Those treatments may include: