Which statement best differentiates a closed head injury from an open head injury?

• A. Open head injury involves no skull fracture.
• B. Closed head injury has skull fracture with exposure of brain tissue.
• C. Closed head injury has no skull fracture and brain injury without penetrating injury.
• D. Open head injury has no skull fracture but penetrating injury.

Answer: (C)

The key idea is whether the skull and dura are breached and brain tissue is exposed. In a closed head injury, the skull remains intact and the brain is injured without a penetrating wound—no entry of an object and no brain tissue exposure to the outside. In contrast, an open (penetrating) head injury involves a breach of the skull and dura, with brain tissue potentially exposed to the environment.

That’s why the best statement is that a closed head injury has no skull fracture and brain injury without penetrating injury. The other options imply scenarios that contradict this distinction—open head injuries involve breach of the skull and exposure of brain tissue, and a closed head injury with skull fracture and exposure doesn’t fit the definition.