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Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people.
Closed head injury (coup contrecoup) can damage more than the impact sites on the brain, as axon bundles may be torn or twisted, blood vessels may rupture, and elevated intracranial pressure can distort the walls of the ventricles. [7] [10] [11] Diffuse axonal injury is a key pathology in concussive brain injury. [5] The visual system may be ...
Most people with severe closed head injury either die or recover enough to live independently; middle ground is less common. [10] Coma, as it is closely related to severity, is a strong predictor of poor outcome. [11] Prognosis differs depending on the severity and location of the lesion, and access to immediate, specialised acute management.
A closed (non-missile) head injury is where the dura mater remains intact. The skull can be fractured, but not necessarily. A penetrating head injury occurs when an object pierces the skull and breaches the dura mater. Brain injuries may be diffuse, occurring over a wide area, or
Decompressive craniectomy (crani-+ -ectomy) is a neurosurgical procedure in which part of the skull is removed to allow a swelling or herniating brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke, Chiari malformation, and other conditions associated with raised intracranial pressure. Use of ...
Treatment is generally based on the extent and location of the injury to structures inside the head. [1] Surgery may be performed to seal a CSF leak that does not stop, to relieve pressure on a cranial nerve or repair injury to a blood vessel. [1] Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis.
A cranial burst skull fracture, usually occurring with severe injuries in infants less than 1 year of age, is a closed, diastatic skull fracture with cerebral extrusion beyond the outer table of the skull under the intact scalp. [citation needed] Acute scalp swelling is associated with this type of fracture.
It is suitable for patients with moderate to severe traumatic brain injury. The WPTAS is the most common post-traumatic amnesia scale used in Australia and New Zealand. [32] An abbreviated version has been developed to assess patients with mild traumatic brain injury, the Abbreviated Westmead PTA Scale (AWPTAS). [33]