Closed Head Injury
(Traumatic Brain Injury; Head Trauma)
by Cynthia M. Johnson, MA
A closed head injury is trauma to the head that does not cause a break in the skull. The brain and soft tissue can be damaged by violent movement. This can lead to bleeding and swelling inside the head.
This problem is caused by a blow to the head or severe jerking motions of the head, neck, or body. Common causes are:
Falls raise the risk of this problem in older adults. Other things that may raise the risk are:
A person may have problems right away or in the days and weeks after the trauma. Problems may be:
The doctor will ask about your symptoms and health history. You will be asked how the injury happened. If you cannot speak, others may answer questions for you.
Images may be taken of the brain. This can be done with a CT scan.
Brain function may be tested. This can be done with neuropsychological tests.
Treatment will depend on how severe the injury is. The goal of treatment is to give the brain time heal and to avoid lasting problems. Choices are:
Mental and physical rest will be needed to give the brain time to heal. This includes limiting mental tasks like work or school. Problems may get worse when a person returns to normal activity too soon. It can also slow healing.
It will take longer to return to a sport or other physical activity. Having a second head injury before the brain has fully healed can lead to severe problems.
Moderate or Severe Injury
Emergency care will be needed. It may be:
People who are not helped by these methods may need surgery. Choices are:
Rehabilitation may be needed to help with long term healing. Choices are:
The risk of this problem may be lowered by:
Falling is a common cause in older adults. The risk may be lowered by:
American Academy of Neurology
Brain Injury Association of America
The Brain Injury Association of Canada
Ontario Brain Injury Association
Concussion and mild traumatic brain injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/concussion-and-mild-traumatic-brain-injury. Accessed February 16, 2021.
Management of Concussion/Mild Traumatic Brain Injury Working Group. Veterans Affairs/Department of Defense clinical practice guideline for management of concussion/mild traumatic brain injury. VA/DoD 2016.
Traumatic brain injury and concussion. US Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/traumaticbraininjury/index.html. Accessed February 16, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM