Open Head Injuries

When a strong force breaks the skull or when an object penetrates skull bone and brain tissue, it is a traumatic brain injury referred to as an open head injury. Open head injuries or skull fractures occur in a variety of ways. In the past 20 years, there has been a rise in the number of open head injuries and penetrating injuries. This increase has been attributed to gun shot wounds, motor vehicle accidents and occupational accidents.

Types of Open Head Injuries
Some of the most common skull fractures are basilar fractures, diastatic fractures, linear and depressed fractures. Linear skull fractures refer to a crack or break in the skull. Linear fractures are the most common type of traumatic brain injury, occurring in 62% of people with traumatic brain injuries. The treatment needed for a linear skull fracture varies greatly. Some of the treatment factors include location of the fracture, and if the fracture penetrates the brain tissue. If the fracture extends into the sinus cavity, there can be leakage of the cerebrospinal fluid through the ears or nose. The cerebrospinal fluid is responsible for the protection of the brain, both immunological and mechanical. It also helps to decrease intracranial pressure and facilitates blood perfusion in the brain.

A depressed skull fracture occurs when broken skull fragments penetrate brain tissue or press down on top of the brain. A depressed skull fracture most often occurs if a victim is struck in the head with a blunt object. When the skull fragments enter the brain tissue, the tissue that is involved is destroyed. Diastatic fractures occur along the areas between the bones in the head. These types of fractures are most commonly seen in newborns and older infants. Basilar skull fractures, which are a break at the base of the skull, are rare but when they do occur they are very serious.

Complications from Open Head Injuries
Complications from open head injuries include the following; seizures, dementia, paralysis, coma and death. As stated earlier, if bone or other objects come in contact with brain tissue, brain damage or brain tissue death occurs. Another very serious complication from open head injury is infection. Very often the infection that occurs with open head injury is either bacterial or viral meningitis. Meningitis must be treated very aggressively by health practitioners because if untreated the infection can be fatal.

Treatment of Open Head Injury
The majority of open head injury cases, surgery is needed in order to repair the fractured skull and to stop the bleeding. Some of the interventions that surgeons use to treat open head injury include; controlling the amount of brain swelling, protecting brain tissue from further injury, removing bone fragments and replacing damaged skull areas with synthetic skull pieces. Other treatments include drilling holes into the skull to relieve pressure (craniotomy), draining blood or cerebrospinal from the skull also to decrease intracranial pressure. Corticosteroids are a medication given in an attempt to control swelling.

If you are involved in a case where someone was a victim of traumatic brain injury, contact our medical legal consulting office at Medical Jurisprudence, Inc. We can provide a variety of services to help you provide the representation that your client deserves.

Reference:
McCance, Kathryn L. & Huether, Sue E. Pathophysiology: The Biological Basis for Disease in Adults and Children. Mosby-Year Book 5th Edition 2003.