Traumatic Brain InjuryTypes of Traumatic Brain Injury: Part Two

Closed brain injuries are typically the result of blunt force trauma and do not generate a visible wound or compromise the protective scalp/skull barrier. Unfortunately, closed brain injuries are equally dangerous as compared to open head injuries for a variety of reasons.

In many closed head injury cases, the exact location of the trauma may not be obvious, however in some situations, swelling might produce a visible indication of the general place in which the patient experienced a blow or profound force.

As mentioned in the discussion on open head injuries, a CT, or computed tomography scan may be performed to verify any damage to the skull or facial bones. This form of imaging is essentially an advanced type of x-ray. A magnetic resonance imaging test, or MRI, is best used to diagnose problems of the soft tissue. Whenever there is concern about damage to the brain itself, an MRI is the best choice of testing because it usually takes priority over bone damage. Both of these tests may be performed with or without contrast dye to develop a more precise image of the brain and possible injuries within.

Internal bleeding or the collection of fluid within the head is referred to as an intracranial hematoma. Sometimes, this bulge may develop on the outside of the skull and from a risk standpoint, this is preferred. The skin on our scalp is much more flexible than our bones, and can stretch to accommodate this excess fluid. When a hematoma or swelling happens inside the skull, there is a very limited amount of space in which the brain can adapt to the additional volume.

The presence of excess fluid can also significantly alter the typical ionic balances found within the brain. Neurons use charged particles and electrical gradients to transmit signals and communicate through the release of hormones, so whenever the presence of molecules like sodium, potassium and calcium are distorted from the influx of fluid or blood, the neurons are unable to function appropriately.

In the event that a patient is experiencing uncontrollable swelling of the brain, doctors may choose to conduct an invasive surgery where a portion of the skull is removed to allow the brain more room to expand. If the brain continues to swell without intervention, the soft tissue could cut off circulation of vital blood vessels that are feeding the brain with oxygen and other nutrients. When neuron cells in the bran are starved of oxygen (anoxia), there is a very likely risk that they will die and be unable to communicate or transmit signals.

In addition to anoxia, blunt force trauma itself can often physically damage the fragile neurons and prevent them from functioning properly.

Unfortunately, neuronal death is often irreversible and our brains only hold a limited capacity to grow new replacement neurons. Although it is impossible to predict, some patients have shown the ability to enhance their healthy neuron pool or extend and grow the neurons that still exist following a severe closed head injury.

The most common symptoms associated with a closed traumatic brain injury include unconsciousness, impaired speech, defective motor function (can be on one side or both), impaired muscle tone, loss of memory and/or confusion.

Location of a closed head injury can often be predicted based on the individual’s symptoms. For example, because the motor neurons in the left side of the brain control function on the right side of the body, impaired function of the right arm might suggest a left hemisphere brain injury. The loss of sensory perception might indicate a somatosensory cortex injury and loss of memory might indicate a potential problem with the hippocampus. Because we know so much about which areas of the brain control certain functions, we may have a general idea of where certain problems might be located.

The imaging techniques mentioned above are the only way to verify the exact location of a close TBI.

You should also find our article: Understanding the Basics of Brain Injury Starts With Anatomy to be very helpful.

The car accident and personal injury lawyers at Martin + Colin, P.C., handle brain injury cases.  If you have been hurt in an accident due to the negligence of another person, our attorneys may be able to help.  Please email us by using the ‘Contact Us’ form on this page.

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