A closed head injury is a brain injury.  They are often called closed head injuries because there are no obvious open wounds to the skull.  But be assured that the brain can be injured even if there are no obvious wounds.  The injury to the brain occurs most commonly because of the sharp acceleration - deceleration forces that impact the head.  Most commonly these forces are present in motorcycle crashes whether you are wearing a helmet or not.  You can think of the brain as a mass of jelly inside a hard container.  If you move the container quickly in one direction and then violently move the container in the opposite direction in is clear that the jelly hits up against the inside of the container first on acceleration and then on deceleration as the container is moved in the opposite direction.  This is called coup - countercoup.  The brain is often injured as a result.

Brain injury can occur whether or not there is a loss of consciousness.   Symptoms can be quite unremarkable and may not even be very noticeable to the injured or others observing him or her.  Immediately after a motorcycle crash there may or may not be a period of impaired consciousness followed by confusion, lack of memory, disorientation and a sense of searching for words.  Your balance may also be somewhat effected.

The first 24 hours after an injury are critical as the brain responds to the injury.  Symptoms to be on the watch for include:

• lethargy - general feeling of tiredness or lack of energy
• confusion - fleeting thoughts from one to another
• irritability - easily gets angry or short-tempered
• severe headache - that tend to be out of proportion to the injury
• changes in speech, vision and / or movement - indicated injury to the cerebellum
• vomiting - can come in spurts or be prolonged
• seizure - can and do happen
• coma - an unarousable state
• long and short term memory loss - either since or before the crash
• slowed thinking - or a searching for words
• distorted perception - reaching for objects and missing
• problems concentrating - often asking "what was I doing"
• inability to pay proper attention - flight of memory from one subject to another
• problems communicating including oral or written - may compensate by using simple words
• poor executive function - planning for example
• mood or personality changes  - often inappropriate behavior like laughing out loud

If any of these symptoms are present make sure the doctor knows about them and then make sure the doctor takes you seriously and has teh appropriate tests performed to demonstrate injury such as Ct's, MRI's and PET scans if necessary.

Some resources are:

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