Head trauma is a common reason for an emergency room visit. Traumatic brain injury (TBI) accounts for more than 1 in 6 injury-related hospital admissions each year, and a large number of people who suffer head injuries are children.
Head trauma can be either closed, as in secondary to a hard blow to the head without skull penetration, or open (penetrating), meaning a trauma that was able to penetrate the skull and enter the brain. Commonly, penetrating head traumas are seen after high-speed collisions or gunshot wounds.
There are multiple types of head trauma—including scalp wounds, skull fractures, and concussions—in which the brain is shaken. Head trauma may result in bleeding either inside or around the brain, leading to a categorization of brain bleeds secondary to location (subdural hematoma, intracranial hemorrhage, subarachnoid hemorrhage, epidural hematoma). Given the prevalence, as well as the morbidity, all clinicians should understand the basic principles of evaluation and management of patients with head trauma.