A closed head injury is trauma to the head that causes the skull and brain to knock or shake. Internal damage can occur to the:
This damage can cause swelling or pressure on the brain. The injury can be throughout the brain and skull or it may confined to 1 area.
Often times, the head injury is minor. However, it can serious and life threatening. It requires care from a doctor.
Closed head injuries are caused by trauma to the head. This is often due to:
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Factors that may increase your chance of a closed head injury include:
Symptoms can appear right away, or the days and weeks following the injury.
Concussion symptoms include:
Symptoms of a skull fracture or focal brain injury:
Be sure you know which symptoms your doctor needs to know about right away. If you have been evaluated for a closed head injury and your symptoms are getting worse, get medical help right away.
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a neurologist for special testing.
Tests may include:
Imaging tests evaluate the brain and other structures:
Imaging tests are not routinely done in children with minor head injuries. Your child may be observed to determine if imaging tests are needed.
Talk with your doctor about the best treatment plan for you. Treatment will depend on:
Treatment options include the following:
For minor injury with little or no symptoms, your doctor may advise that you watch for symptoms to develop in the days and weeks that follow.
If you have a concussion, a responsible adult will need to observe you. You may also need to limit drug and alcohol use.
You may need more testing. These tests assess how your brain functions. The results can help your doctor determine:
You may be referred to a counselor to take part in a rehabilitation program to improve functioning.
Medications can be used to:
This usually involves making “burr holes” in the scalp and skull and draining the clotting blood. Sometimes a section of the skull is removed to relieve pressure. This is called a craniotomy.
To help reduce your chance of a closed head injury:
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: http://www.ebscohost.com/dynamed. Updated April 29, 2009. Accessed May 19, 2009.
The management of minor closed head injury in children. Committee on Quality Improvement, American Academy of Pediatrics. Commission on Clinical Policies and Research, American Academy of Family Physicians. Pediatrics. 1999;104:1407-1415.
10/5/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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;95(1):1-9.
Last reviewed November 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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