Closed Traumatic Brain Injury (cTBI)

Key Statistics

  • 90% of all TBIs (CDC 2023)
  • 12-25% mortality in severe cases
  • Average hospital stay: 10-21 days

Medical Definition

Closed Traumatic Brain Injury (cTBI):
"Non-penetrating injury causing diffuse axonal damage through mechanical force transfer (Journal of Neurotrauma, 2023)"

Closed TBI Features

  • Intact skull
  • Diffuse damage
  • Common in MVA

Penetrating TBI Features

  • Skull fracture
  • Focal damage
  • Infection risk

Injury Mechanisms

Rotational Forces

  • DAI Grade I-III
  • Angular acceleration >50 rad/s²
  • 15% result in coma

Acceleration-Deceleration

  • Impact velocity >15 mph
  • Contrecoup lesions
  • 30% cortical impact

Blunt Trauma

  • Force >50G
  • Coup injuries
  • 25% subdural hematoma

Symptoms

Physical

  • Post-traumatic amnesia
  • Photophobia (68% cases)
  • Vestibular dysfunction

Cognitive

  • Executive dysfunction
  • Processing speed ↓40%
  • Working memory deficits

Emotional

  • Emotional lability
  • Anxiety (42% prevalence)
  • Impulse control issues

Diagnosis Protocol

  1. CT Scan (ASNR guidelines)
  2. Diffusion Tensor Imaging
  3. Pupillometry assessment

Treatment Timeline

Acute (0-72h) Subacute (1-6w) Chronic (>6w)
ICP monitoring Physical therapy Vocational rehab
Neuroprotectants Speech therapy Support groups

Complications

Acute Risks

  • Intracranial hypertension
  • Midline shift >5mm
  • Brain herniation

Chronic Risks

  • 30% epilepsy risk
  • Neurodegeneration 2.5× risk
  • CSF leakage

Prevention Strategies

  • MIPS helmet technology
  • Elderly balance training
  • NFL Head Health Initiative