There are several ways head injuries may be categorized. According to the Children’s Hospital at Montefiore, head injuries “are classified by mechanism (close vs. penetrating injury), morphology (fractures, focal intracranial injury and diffuse intracranial injury, and severity (mild, moderate, and severe).” A traumatic brain injury (TBI) occurs because of sudden damage to the brain. The American Association of Neurological Surgery explains that TBI “is a disruption in the normal functioning of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters brain tissue.” Traumatic brain injury is a medical condition that can affect one’s physical, neurological, and/ or emotional functioning.
Mechanism of Injury
Penetrating injuries, also known as open head injuries, occur when the skin and the dura (the outer layer of tissue that covers and protects the spinal cord and brain) are penetrated either by a piece of one’s skull or a foreign object. A closed head injury occurs when the skin and dura remain intact and are not penetrated. The severity of these injuries is informed by the velocity of impact. Examples of low-velocity injuries could include smacking one’s head on an open cabinet door, an aggressive tackle in a hockey game, or an accidental hit to the head with a baseball bat. Examples of a high-velocity injury could include being hit by a moving car, falling from a high distance (e.g., an upper-story window), or automobile accidents.
Morphology of Injury
Skull fractures can occur in the cranial vault (the space that encases and protects the brain) or skull base (bottom part of the skull). Most skull fractures can be seen on an x-ray of the skull. Identifying a skull fracture can be helpful as it is often indicative of the force of the injury.
Severity of Injury
TBIs are divided into three categories based on their severity: mild TBI (concussions), moderate TBI, and severe TBI. When assessing the severity of a traumatic brain injury, medical health professionals often rely on the Glasgow Coma Scale. According to the Royal College of Physicians and Surgeons of Glasgow, “the Glasgow Coma Scale provides a practical method for assessment of impairment of conscious level in response to defined stimuli.” The Glasgow Coma Scale is a 15-point test that checks an individual’s ability to follow directions (e.g., moving one’s eyes, limbs, etc.). Based on one’s abilities, the individual is then scored from three to fifteen, where lower scores are indicative of more severe injuries. In addition to the Glasgow Coma Scale, evaluating medical professionals also rely on the presence of certain symptoms (e.g., the coherence of the individual’s speech) when delineating the severity of his or her injury. According to the Centers for Disease Control and Prevention (CDC), an individual with a mild TBI will score 13 to 15 on the Glasgow Coma Scale, an individual with a moderate TBI will score 9 to 12 on the Glasgow Coma Scale, and an individual with a severe TBI will score 3 to 8 on the Glasgow Coma Scale.
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