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Closed Head Injuries
and Recovery
What is
TBI / Closed Head Injury?
Traumatic brain injury
is sudden physical damage
to the brain. The damage
may be caused by the head
forcefully hitting an
object such as the
dashboard of a car
(closed head injury) or
by something passing
through the skull and
piercing the brain, as in
a gunshot wound
(penetrating head
injury). The major causes
of head trauma are motor
vehicle accidents. Other
causes include falls,
sports injuries, violent
crimes, and child abuse.
The physical,
behavioral, or mental
changes that may result
from head trauma depend
on the areas of the brain
that are injured. Most
injuries cause focal
brain damage, damage
confined to a small area
of the brain. The focal
damage is most often at
the point where the head
hits an object or where
an object, such as a
bullet, enters the brain.
In addition to focal
damage, closed head
injuries frequently cause
diffuse brain injuries or
damage to several other
areas of the brain. The
diffuse damage occurs
when the impact of the
injury causes the brain
to move back and forth
against the inside of the
bony skull. The frontal
and temporal lobes of the
brain, the major speech
and language areas, often
receive the most damage
in this way because they
sit in pockets of the
skull that allow more
room for the brain to
shift and sustain injury.
Because these major
speech and language areas
often receive damage,
communication
difficulties frequently
occur following closed
head injuries. Other
problems may include
voice, swallowing,
walking, balance, and
coordination
difficulties, as well as
changes in the ability to
smell and in memory and
cognitive (or thinking)
skills.
What Causes Closed
Had Injuries
Head trauma may cause
a concussion, in which
there is a brief loss of
consciousness without
visible structural damage
to the brain. In addition
to loss of consciousness,
initial symptoms of brain
injury may include:
After a head injury,
there may be a period of
impaired consciousness
followed by a period of
confusion and impaired
memory with
disorientation and a
breakdown in the ability
to store and retrieve new
information. Others
experience temporary
amnesia following head
injury that begins with
memory loss over a period
of weeks, months, or
years before the injury
(retrograde amnesia). As
the patient recovers,
memory slowly returns.
Post-traumatic amnesia
refers to loss of memory
for events during and
after the accident.
Closed
head injuries
Closed
head
injury
refers to
brain
injury
without
any
penetrating
injury to
the brain.
It may be
the result
of a
direct
blow to
the head;
of the
moving
head being
rapidly
stopped,
such as
when a
person's
head hits
a
windshield
in a car
accident;
or by the
sudden
deceleration
of the
head
without
its
striking
another
object.
The
kind of
injury the
brain
receives
in a
closed
head
injury is
determined
by whether
or not the
head was
unrestrained
upon
impact and
the
direction,
force, and
velocity
of the
blow. If
the head
is resting
on impact,
the
maximum
damage
will be
found at
the impact
site.
A
moving
head will
cause a "contrecoup
injury"
where the
brain
damage
occurs on
the side
opposite
the point
of impact,
as a
result of
the brain
slamming
into that
side of
the skull.
A closed
head
injury
also may
occur
without
the head
being
struck,
such as
when a
person
experiences
whiplash.
This
type of
injury
occurs
because
the brain
is of a
different
density
than the
skull, and
can be
injured
when
delicate
brain
tissues
hit
against
the rough,
jagged
inner
surface of
the skull.
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