Closed head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. A closed head injury is the leading cause of death in children under 4 years and the most common cause of physical disability and cognitive impairment in young people. Overall, closed head injuries and other forms of mild traumatic brain injury account for about 75% of the approximately 1.7 million brain injuries occurring each year in the United States. Brain injuries such as closed head injury may result in lifelong physical, cognitive, or psychological disorders and, thus, are of primary concern with public health.
Video Closed-head injury
Cause
Head injuries are mainly caused by vehicle accidents, falls, violent acts, and sports injuries. Falls accounts for 35.2% of brain injury in the United States, with the highest rates for children aged 0-4 years and adults aged 75 years and older. Head injuries are more common in men than women in all age groups. The boys aged 0-4 years had the highest brain injury rates associated with hospital visits, hospitals, and combined deaths. Some minor traumatic brain injuries that last for a short period of time (hours to weeks), often seen with sports-related injuries, may cause neurological or cognitive deficits or death.
Traumatic brain injuries associated with explosions are often closed head injuries and are caused by rapid changes in atmospheric pressure, objects that fall off from explosions that hit people, or people thrown into explosion-related explosions showed a recent increase in incidence with the return of veterans from Iraq in such a way that traumatic brain injury has created a "signature injury" Operation Iraqi Freedom
Closed head injuries can range from minor injuries to debilitating traumatic brain injury and can cause severe brain damage or death. Common closed head injuries include:
- concussions - head injuries result in temporary normal brain function dysfunction. Almost half of the total concussions reported annually are associated with sports
- Intracranial hematoma - a condition in which a ruptured blood vessel causes a pool of blood to form around the brain (subdural hematoma) or between the brain and the skull (epidural hematoma). Intracranial hematomas cause increased pressure on the brain and require immediate medical attention.
- cerebral contusions - bruises to the brain tissue as a result of trauma. Contusion is local, separating them from concussions.
- diffuse axonal injury - this injury is often seen in car accidents and causes permanent damage to the brain. Severe axial axillary injury often results in coma or vegetative state.
Maps Closed-head injury
Symptoms
If symptoms of head injury are seen after an accident, medical care is required to diagnose and treat injuries. Without medical care, injuries can continue and cause brain damage, disability, or further death.
Common symptoms
Because brain swelling that produces these symptoms is often a slow process, these symptoms may not show up for days until weeks after the injury. Common symptoms of closed head injury include:
- headache
- hungover
- nausea
- vomit
- talk lisp
Symptoms of severe injuries
Severe head injuries can lead to a permanent vegetative state or death, therefore being able to recognize symptoms and gain medical attention is essential. Symptoms of severe head-cover injury include:
- comma
- seizures
- lose consciousness
Secondary symptoms
Secondary symptoms are symptoms that arise during the rehabilitation of injuries including problems of social competence, depression, personality changes, cognitive disability, anxiety, and changes in sensory perception. More than 50% of patients suffering from traumatic brain injury will experience psychiatric disorders. Although an appropriate level of anxiety after a brain injury is unknown, a 30-year follow-up study of 60 patients found 8.3% of patients developed panic disorder, 1.7% developed anxiety disorder, and 8.3% developed specific phobias. Patients who are recovering from head injury or traumatic brain often suffer from decreased self-esteem and depression. This effect is often associated with difficulties reentering the community and frustration with the rehabilitation process. Patients suffering from head injuries also exhibit higher unemployment rates, which may lead to the development of secondary symptoms.
Classification
Glasgow Coma Scale
The Glasgow Coma scale is generally used to assess the severity of traumatic brain injury, including closed head injuries. This scale tests the eye, verbal, and motor responses of patients. This scale goes up to fifteen points; with fifteen least injuries, less than eight being a severe brain injury, and three being a vegetative state.
ASCOT
The probability of ASCOT survival summarizes some of the variables measured in the Glasgow Coma Scale but also includes systolic blood pressure, respiratory rate at admission, and anatomic injury. ASCOT is found to be the most sensitive tool for determining the severity of head injury in children and is effective in predicting injury outcomes.
Mechanisms based on
A mechanism-based TBI classification system divides traumatic brain injury (TBI) into closed and translucent head trauma; based on the way the person was hurt.
Treatment
There are several types of treatments available for those who suffer from a closed head injury. The type of treatment chosen may depend on several factors including the type and severity of the injury and the injury effects that the patient has. Treatment varies for each patient and may include some types of treatment, depending on the patient's specific needs. Early treatment is essential to restore lost motor function after injury, but cognitive ability can be recovered regardless of the past since the injury.
Pharmacotherapy
Pharmacotherapy is the use of drugs to treat an illness. There are several different medications that have been used to relieve symptoms experienced after head injury including anti-depressants such as amitriptyline and sertraline. The use of these drugs has been linked to decreased depression and increased function in the social and work environment. An antidiuretic called Desmopressin Acetate (DDAVP) has also been shown to improve memory performance in patients. Recent studies have examined the effects of progesterone prevention on brain injury. Phase III trials are currently being conducted in 17 medical centers across the United States. Initial results showed a 50% reduction in mortality in those treated with progesterone and showed improved functional outcomes. Overall, the efficacy of pharmacotherapy treatment is dependent on the treatment used and the symptoms targeted by the treatment.
Patient education
Patient education has proven to be one of the most effective ways to reduce secondary symptoms seen with a closed head injury. Patient education often includes working with a therapist to review symptoms management and learn about returning to regular activities. Educational initiatives have also been shown to reduce the occurrence of PTSD in victims of head injuries.
Cognitive rehabilitation
Many patients with severe injuries require therapy to regain basic motor and cognitive abilities. Cognitive rehabilitation aims to improve attention, memory function, and cognitive processing speed. The type of rehabilitation used is adjusted to the clinical needs of the patient depending on the severity and type of injury suffered.
More
Other types of rehabilitation focus on improving the patient's self-esteem by giving him tasks that can be successfully resolved despite cognitive changes as a result of brain injury. This process can help reduce secondary symptoms such as feelings of worthlessness, depression, and social anxiety. Some rehabilitation programs use team building exercises and problem-solving activities to help patients learn to work with their disabilities.
Prevention
Many closed head injuries can be prevented by the use of appropriate safety equipment during hazardous activities. Common safety features that can reduce the chances of having a brain injury include helmets, hard hats, car seats, and seatbelts. Other safety precautions that may reduce a person's risk for brain injury are not to drink and drive or allow oneself to be encouraged by someone who has been drinking or who is otherwise impaired.
Helmets can be used to reduce closed-head injuries acquired during athletic activities, and are deemed necessary for sports such as American "tackle" soccer, where frequent head impact is a normal part of the game. However, recent studies question the effectiveness of even American football helmets, where helmet protection is assumed to promote more headaches, a behavior known as risk compensation. The results appear to have increased, not decreased, in TBI. A similar sport of football and rugby rules Australia is always played without a helmet, and sees fewer traumatic brain injuries. (See Australian football injuries.)
Bicycle helmets are the most widely promoted helmet type, based on the assumption that non helmeted cycling is a dangerous activity, with the risk of major brain injury. However, the available data clearly shows that it is wrong. Cycling (with about 700 American deaths per year from all medical causes) is a very small source of fatal traumatic brain injury, whose total in America is around 52,000 per year. Similarly, cycling only causes 3% of non-fatal American TBI.
However, a bicycle-helmet promotional campaign is commonplace, and many US jurisdictions have enforced mandatory bike-helmet laws for children. Some such jurisdictions, some Canadian provinces, plus Australia and New Zealand mandate bicycle helmets even for adults. The bicycle-helmet educational campaign aimed at children claimed an increase in helmet usage from 5.5% to 40.2% led to a claimed decline in associated bicycle-related head injury of almost 67%. However, other sources have pointed out that the promotion of bicycle helmets reduces cycling, often without a per-cyclist reduction in TBI.
Estimates of the use of helmets by American adults vary. One study found that only 25-30% of American adults were wearing helmets while riding bicycles, despite years of promotion and despite the adoption of helmeted motorcyclists as part of their uniforms. It seems that American adults generally recognize ordinary cycling as a very small risk.
Following the commercial success (as opposed to public health) of a bicycle helmet, there has been a successful attempt to promote the sale of ski helmets. Again, the results are less impressive, with large increases in helmet use that do not result in a reduction in fatality, and with injury reductions limited to lacerations, contusions, and mild concussions, compared with more serious head injuries.
There is already a rare campaign to ride a helmet. Unfortunately, just as people are overestimating the dangers of TBI cycling, they greatly underestimate the risk of driving, which remains the largest source of TBI in developed countries, despite the protective effect of seat belts and airbags.
See also
- Cerebral funeral
- Konkusi
- Diffuse axons injury
- Intracranial hemorrhage
- Traumatic brain injury
References
Source of the article : Wikipedia
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