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
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
- CT Scan (ASNR guidelines)
- Diffusion Tensor Imaging
- 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