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Closed Head Injury
(Traumatic Brain Injury)
- Blood vessels
- Layers between the skull and scalp
- Accidents (such as automobile, work-related, sports-related)
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- Being of advanced age (due to greater risk of falls)
- Being of relatively young age (higher risk of motor vehicle accidents)
- Playing high-impact sports (especially boxing, basketball, baseball, football)
- Being physically abused (such as shaken baby syndrome)
- Having a previous head injury or concussion
- Abusing alcohol or drugs
Symptoms of a concussion:
- Confusion, loss of memory about the accident
- Low-grade headache or neck pain
- Having trouble remembering, paying attention, organizing, making decisions
- Slowness in thinking, acting, speaking, or reading
- Feeling fatigued or tired
- Change in sleeping pattern (such as sleeping longer, having trouble sleeping)
- Loss of balance, feeling light-headed or dizzy
- Increased sensitivity to sounds, light, distractions
- Blurred vision or eyes that tire easily
- Loss of sense of taste or smell
- Ringing in the ears
- Feeling sad, anxious, or listless, lacking motivation
- Becoming easily irritated or angry for little or no reason
Symptoms of a
or focal brain injury:
- Leaking cerebrospinal fluid
- Blood in the ears
- Weakness or numbness of the limbs
- Swelling, tenderness at injury site
- Hearing loss
- Progressive worsening of cognition or level of alertness
- CT scan—to make pictures of structures inside the head
- CT angiography—to identify arterial bleeding
- MRI scan—to make pictures of structures inside the head
- Blood tests
- Neurological examination
- Neuropsychological tests
- EEG (electroencephalogram)—a noninvasive test used to evaluate brain function
- Your symptoms
- Location and severity of the injury
Monitoring and Observation
- How you are recovering
- Whether you are ready to return to high-impact activities
- Reduce pressure inside the head or brain swelling
- Prevent seizures (given in some cases)
- Reduce pain
- Do not drink alcohol and drive.
- Do not take medicines that may make you sleepy, especially when driving or using heavy equipment.
- Obey speed limits and other driving laws.
- In vehicles, always use seatbelts, shoulder harnesses, and child safety seats. Only use child safety seats when traveling. Do not use them outside of the vehicle.
- Learn about the air bags in your car.
Wear a helmet when:
- Riding a bike or motorcycle
- Playing a contact sport like football, soccer, or hockey
- Using skates, scooters, and skateboards
- Catching, batting, or running bases in baseball or softball
- Riding a horse
- Skiing or snowboarding
- Wear mouth guards, face guards, pads, and other safety gear while playing sports.
- Make sure your child's play surface is soft and free of rocks, holes, and debris.
Reduce falling hazards at home for children and adults, by:
- Using handrails when walking up and down stairs
- Having safety gates by stairs and safety guards by windows
- Using grab bars in the bathroom
- Placing non-slip mats in the bathroom
- Keeping walkways clear to avoid tripping
- Making sure rooms and hallways are well-lit
- Keep firearms and bullets locked safely away.
American Academy of Neurology http://www.aan.com
Brain Injury Association of America http://www.biausa.org
The Brain Injury Association of Canada http://biac-aclc.ca
Ontario Brain Injury Association http://www.obia.on.ca
American Academy of Pediatrics. The management of minor closed head injuries in children. Pediatrics. 1999;104:1407-1415.
Closed head injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2009. Accessed May 19, 2009.
10/5/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Parikh SN, Wilson L. Hazardous use of car seats outside the car in the United States, 2003-2007. Pediatrics. 2010;126(2):352-357.
4/1/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Choosing wisely. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed April 1, 2014.
5/12/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Cantor J, Ashman T, et al. Evaluation of short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization. Arch Phys Med Rehabil. 2014 Jan;95(1):1-9.e3.
- Reviewer: Michael Woods, MD
- Review Date: 12/2013
- Update Date: 05/12/2014