A closed head injury is a brain injury where the skull is not penetrated. Generally these types of injures are the result of direct trauma to the head from a car accident or slip and fall.A closed head injury can be very serious and a number of factors must be evaluated. Direct trauma to the head can lead to swelling of the brain and/or intracranial pressure. These symptoms can destroy brain cells, brain tissue, and connective tissue. This very often leads to permanent brain damage.Very often a closed head injury is related to other types of brain injures such as a diffuse axonal injury, a concussion, or a hematoma.