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Closed-head injuries are caused primarily by vehicular accidents, falls, acts of violence, and sports injuries. [4] Falls account for 35.2% of brain injuries in the United States, with rates highest for children ages 0–4 years and adults ages 75 years and older. [3] Head injuries are more common in men than women across every age group. [3]
[7] [10] 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]
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
Mechanism-related classification divides TBI into closed and penetrating head injury. [10] A closed (also called nonpenetrating, or blunt) [14] injury occurs when the brain is not exposed. [15] A penetrating, or open, head injury occurs when an object pierces the skull and breaches the dura mater, the outermost membrane surrounding the brain. [15]
A cerebral laceration is a type of traumatic brain injury that occurs when the tissue of the brain is mechanically cut or torn. [1] The injury is similar to a cerebral contusion; however, according to their respective definitions, the pia-arachnoid membranes are torn over the site of injury in laceration and are not torn in contusion.
A skull fracture is a break in one or more of the eight bones that form the cranial portion of the skull, usually occurring as a result of blunt force trauma.If the force of the impact is excessive, the bone may fracture at or near the site of the impact and cause damage to the underlying structures within the skull such as the membranes, blood vessels, and brain.
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. [2] [3] A basilar skull fracture occurs in about 12% of people with a severe head injury. [1]
[10] DAI can occur across the spectrum of traumatic brain injury (TBI) severity, wherein the burden of injury increases from mild to severe. [11] [12] Concussion may be a milder type of diffuse axonal injury. [12] [13]