Classificationtypes of traumatic brain injury

Neurological damage associated with head trauma can be produced in several ways. Traumatic brain injury is classified as open or closed; these types differ in the pattern of injury and neurobehavioural outcome. Open refers to penetration of the skull, as in a depressed skull fracture or bullet wound, the extent depending on the regions damaged by contusion or cerebral oedema. Closed head injury results from acceleration and deceleration of the brain within the hard skull; this often leads to contusion of the brain from a sudden impact and may result in subarachnoid haemorrhage. Different parts of the brain have different densities, and therefore shearing stresses that develop during rapid brain movement cause injury. Furthermore, compression of blood vessels against the falx cerebri or tentorium may result in infarction of the areas which these blood vessels supply. Penetrating traumatic brain injury causes specific and direct loss of neural tissue.

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