Which statement about head injuries is true?

• A. Obvious external damage always indicates severe brain injury
• B. Cerebral edema and increased ICP can occur even with minor external injuries
• C. Open injuries are the only serious ones
• D. Direct trauma never causes brain injury

Answer: (B)

The important idea is that how a head looks on the outside doesn’t reliably reflect what’s happening inside the skull. Cerebral edema and increased intracranial pressure can occur even when the external injury is minor, because brain tissue can swell or bleed internally without obvious surface damage. The skull doesn’t expand, so swelling or accumulating blood raises pressure, which can reduce blood flow to brain tissue and lead to deteriorating function. This means a seemingly small or minor head injury can still pose a serious risk if swelling or pressure builds up.

Obvious external damage isn’t a dependable gauge of severity—some serious brain injuries have little outward damage, while other injuries with apparent wounds may have minimal brain involvement. Open injuries aren’t the only serious type, and closed-head trauma can cause significant brain injury as well. Direct trauma can and does damage the brain, so the best takeaway is that internal brain injury can accompany even minor external findings.