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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.
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.
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
The ICD-10 established a set of diagnostic criteria for PCS in 1992. [38] In order to meet these criteria, a patient has had a head injury "usually sufficiently severe to result in loss of consciousness" [33] [39] and then develop at least three of the eight symptoms marked with a check mark in the table at right under "ICD-10" within four weeks.
[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]
Cerebral contusion (Latin: contusio cerebri), a form of traumatic brain injury, is a bruise of the brain tissue. [2] Like bruises in other tissues, cerebral contusion can be associated with multiple microhemorrhages, small blood vessel leaks into brain tissue. Contusion occurs in 20–30% of severe head injuries. [3]
In March 2011, investigators from Australia and several other countries published the results of the DECRA [5] trial in The New England Journal of Medicine.This was a randomized trial comparing decompressive craniectomy to best medical therapy run between 2002 and 2010 to assess the optimal management of patients with medically refractory ICP following diffuse non-penetrating head injury.