Closed Head Injuries in Traffic Accidents

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December 04, 2012
Edward Smith

Closed head injuries can happen in a traffic accident. A closed head injury is an injury to the brain that happens due to blunt force trauma in a fall, a sports injury or a traffic accident. The brain is generally swollen and bruised with bleeding around the surface of the brain, usually at the site of the force on the head. Sometimes there can be bleeding and bruising on the side of the brain opposite to the direct trauma. This is known as a contracoup injury to the brain.

The symptoms of a closed head injury usually show up immediately if the injury is severe; however, mild head injuries can show up days to weeks following an injury. The major symptoms of a closed head injury include having a loss of consciousness or coma, dilated pupils, seizures, problems breathing, dizziness, headache, nausea, vomiting, speech difficulties, difficulties understanding language, leakage of cerebrospinal fluid leaking from the nose and ears, vision problems and emotional or behavioral issues.

Many people recover completely from a closed head injury. Signs of future problems includes being unconscious for a long period of time as well as the degree to which the person recovers in the first month following the injury. A few people end up in a persistent vegetative state. If the swelling of the brain is too severe, the patient suffers a herniation of the brain through the foramen magnum at the base of the brain, which results in loss of ability to handle one’s own blood pressure, heart rate and breathing. In such cases, the patient dies.

One study looked at the combination of closed head injuries and facial fractures who were treated over a 78 month period of time at a level I trauma center located in Northeast Ohio. Of people who had facial fractures, 17.5 percent of individuals also had a closed head injury of varying severities. Men suffered a closed head injury and facial fractures four times more than was seen in women. Men also sustained very severe intracranial injuries and closed head trauma eight times more often than seen in women. Most patients (59 percent) were between the ages of 16 years to 30 years of age.

In the study, they noted that 61 percent of the time, such injuries were sustained because of a traffic accident. Motorcycle accidents made up fewer injuries but the injuries were generally much more severe than in regular traffic accidents. The ratio of mandible to midface fractures was 1.3 to one. Fewer people with mandible fractures suffered closed head injury by half. This is because the mandible is further away from the skull and fewer skull fractures occur in mandibular injuries. Also, the mandible can take a lot of force before fracturing, thus absorbing the force of the injury.
There were complications to the facial fractures but even in cases where the patient had both cranial injuries and facial fractures, the individual had a 14 percent incidence of complications, which was the same rate as those patients who had no cranial injury with their facial fracture.