Closed Head Injury

About 75% of the 2 million brain injuries yearly accounts for a closed brain injury. This means that nothing directly touches the brain. Not all brain injuries are the same; they differ from their severity. Others may appear minor but later on, significant symptoms can appear.

Closed head injury is another form of traumatic brain injury where the skull remains intact. It is the most common type of head injury.

About 75% of the 2 million brain injuries yearly accounts for a closed brain injury. This means that nothing directly touches the brain. Not all brain injuries are the same; they differ from their severity. Others may appear minor but later on, significant symptoms can appear.

Brain injuries such as a closed head injury can end up having a lifelong physical, psychological, and cognitive impairment.

Causes of Closed Head Injury

A closed brain injury can come from a sharp blow in the head that shakes and traumatize the brain. A common example is a concussion. Since it is closed, the extent of the injury cannot be identified immediately by the naked eye. The patient needs to undergo certain tests to for doctors to see its extent.

This type of head injury can be caused by falls, sports, vehicular accidents, and acts of violence. About 35.2% of closed head injury is caused by fall. Falls are common to toddlers and kids and elderly.


A concussion is a temporary dysfunction of the normal brain functioning. On the other hand, repeated concussion caused by an abuse can result to a lasting damage.

Usually a concussion is treated promptly. If the swelling continues despite the treatment, it can result to death.

Intracranial Hematoma

This happens when there is a ruptured blood vessel. It creates a pool of blood surrounding the brain. This causes an intense pressure on the brain. It can be fatal or can cause a permanent damage in the normal brain functions.

Diffuse Axonal Injury

A diffuse axonal injury occurs when the neurons in the brain are damaged. This is commonly caused by a whiplash or violent shaking, typically as a result of a vehicular accident.

Cerebral Contusion

This is the bruise on the brain tissue as a result of a trauma.

Common Symptoms

Symptoms of head injuries are often seen after the accident and applying medical care is necessary. If a patient is not given immediate medical attention, the injuries can aggravate the situation. It can cause further damages to the brain that may result to permanent disability or even death.

Common symptoms may manifest after a couple of days. Some, after a number of weeks. These symptoms include dizziness, vomiting, nausea, headache and speech slurring.

Severe symptoms can lead to a permanent vegetative state or death. That is why being able to identify the symptoms and undergoing immediate medical attention is crucial.

Severe symptoms include seizures, loss of consciousness and coma.

Secondary Symptoms

These are symptoms that can surface during the phase of rehabilitation after the injury. This includes personality changes, depression, social competence issues, cognitive disabilities, anxiety, and sensory perception changes.

Based on studies almost 50% of patients who suffered from a traumatic brain injury develops a psychiatric disturbance. About 8.3% develop anxiety, about 1.7% develops a panic disorder, and another 8.3% develops a specific phobia.

Some patients also suffer from a decrease self-esteem and depression.

Short-term Symptoms

The following symptoms are common after a closed head injury. They need immediate medical attention:

  • Changes in consciousness such as fainting,loss of consciousness, excessive feeling of sleepiness and drowsiness.
  • Mood changes including behaviour and personality.
  • Eyes rolling back
  • Swelling and bruising on the site of the brain injury
  • Dilated pupils
  • Problems with concentrating including confusion
  • Inability remembering what happened right after the injury
  • Difficulty breathing and changes in the rate of breathing
  • Fluid leak in the eyes, nose and ears. It might me coming from the cerebrospinal fluid.
  • Language and speaking difficulties
  • Blurred vision
  • Hallucinations

Long-Term Symptoms

The long term symptoms vary from person to person and the severity of the head injury. Most of the time, long term symptoms include physical disability and permanent problems with primary functions such as speaking or ability to do the activities of daily living.


The initial treatment for a patient who has a closed head injury is to immediately address the injury and prevent the patient from sustaining further damage. A careful observation of the patient, most especially within the first 24 hours after the injury is done, is undertaken.

Antibiotics is also administered to prevent infection and medications to prevent and reduce the swelling in the brain.

Physical therapy follows to help the patient regain his physical functioning. For some patients, speech therapy is also advised if there are any issues with the their speech. Exercise and occupational therapy are also included if the patients’ ability to do the activities of daily living is impaired after the brain injury.

Most physicians educate or counsel not just the patient but also their families. Psychotherapy helps the patient and their families cope with the emotional aftermath of a traumatic brain injury and the damages to the patients’ brain.

Finally, medications are given to manage the symptoms. Pills are specially given to minimize depression , anger and hallucinations in the patient. These psychological and psychiatric effects of closed head injury usually manifest during treatment and rehabilitation.

3 thoughts on “Closed Head Injury”

  1. I’m interested in treatment of patients diagnosed with neurocognitive disorder secondary to TBI behavioral disturbance.

  2. I had a brain bleed in 2008 that affected my right frontal lobe. A craniotomy was performed and I survived and actually thrived eventually. I still suffer from mild depression and have disturbing dreams often. I saw a talk therapist for over 3 years, but it didn’t heal me like I thought it would. Eventually, I told the psychologist I believed I needed treatment from a neuropsychologist who would understand the type of treatment more effective for a patient who had a Traumatic Brain Injury.
    I haven’t taken any medications for the depression, as the side affects were intolerable. I do take Lamictal because of the acquired seizure disorder from the brain surgery. It is a drug often used for bipolar individuals.
    I am a high intellectually functioning individual with no limitations cognitively. I live in a depressed state all the time.
    My brain bleed was the result of a bacteria which caused heart valve failure and a subdural brain bleed. Two weeks prior to the symptoms manifestation, I was terminated from my executive job and my father passed. After surgery(s), I stayed in the hospital/cognitive rehab for over 115 days. Mid convalescence, my wife filed for divorce and took up with another man.
    My question is: Could the TBI and multiple traumatic events in my life in 4 months time have caused PTSD which is causing the depression?

  3. it was August 14th 1986, i just left home after cleaning up after work, i was on my “77 Kawasaki kz 650”, the bike being 10 years old was in mint condition, a few days earlier i had a “wind jammer” put on my bike, so needed that to help out with the plus 20 mileone one way to work, winter was close and i was on my way to trade it for a “66” dodge split wind shield van, the next thing i remember was gaining consciousness at University of Michigan, i do recall it being on the 4th floor, i had know idea where i was and why, i was 25 and now i am 61(2022), i have existed and am so far till now, as i qet older i see now through my damaged brain the impact of my closed head injury, i have permanent difficulties since, i can’t taste or smell, i get angry quickly, i have a rememburance problem, i am getting worse every day, i often wake up lost, it takes some time but i gain my awareness again, i am thankfull to have lived after that injury, the “what ifs” come to mind often, the doctors told my folks that my brain injury added 10 years to my life, i am grateful back in that day in Michigan you were required to wear a helmet, so i live gratefully each day wanting it to end, i am tired, i have two gifted daughters 1) 38 and the other 8, both very intellagent,


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