Definition

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.

Causes

This problem is caused by a blow to the head or severe jerking motions of the head, neck, or body. Common causes are:

• Accidents, such as motor vehicle, work- and sports-related accidents
• Falls
• Abuse, such as shaken baby syndrome

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Risk Factors

Falls raise the risk of this problem in older adults. Other things that may raise the risk are:

• High-impact sports, such as boxing, basketball, baseball, or football
• Physical abuse
• Alcohol or substance use disorder

Symptoms

A person may have problems right away or in the days and weeks after the trauma. Problems may be:

• Headache
• Nausea and vomiting
• Lightheadedness
• Feeling very sleepy
• Weakness or numbness in arms or legs
• Problems with memory or focus
• Double or blurry eyesight
• Problems speaking
• Changes in mood or behavior
• Seizures
• Loss of alertness

Diagnosis

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

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:

Prevention

The risk of this problem may be lowered by:

• Using seat belts and child safety seats when in a motor vehicle
• Using safe, age-appropriate methods when playing sports
• Wearing a helmet when doing activities, such as:
  • Playing a contact sport like football, soccer, or hockey
  • Riding a bike or motorcycle
  • Using skates, scooters, and skateboards
  • Catching, batting, or running bases in baseball or softball
  • Riding a horse
  • Skiing or snowboarding

Falling is a common cause in older adults. The risk may be lowered 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