by EBSCO Medical Review Board
(Brain Injury, Penetrating; Penetrating Wound to the Head; Wound to the Head, Penetrating)


Penetrating brain injury is when an object enters the skull and harms the brain. It can hurt a small or large part of the brain. It is a threat to life and needs emergency care.

The Brain
Brain nerve pathways
Damage to the brain may be in one area or a larger region.
Copyright © Nucleus Medical Media, Inc.


The injury may be from any object or outside force, such as:

  • A fall, which could cause a piece of the skull to break off and enter the brain
  • A motor vehicle accident
  • A gunshot
  • A stab wound
  • A sports injury
  • Abuse, such as being struck on the head with an object

Risk Factors

Things that may raise the risk of this problem are:


The problems a person may have depend on what caused the injury and how severe it is. Some problems may be:

  • Heavy bleeding from the head
  • Bleeding from the ears
  • Problems breathing
  • Seizure
  • Loss of bowel and bladder function
  • Problems moving
  • Loss of feeling in the limbs
  • Loss of consciousness


The doctor will examine your injury in the emergency room. This is often enough to make the diagnosis. Life-saving treatment may be given at this time.

When the person is stable, images may be taken to look for damage in the brain and skull. This can be done with:


Treatment depends on:

  • How severe the injury is
  • The parts of the brain that were hurt
  • The symptoms the person is having

Initial Treatment

Initial treatment involves lifesaving measures, such as stopping bleeding and providing help with breathing.


Surgery may be done to:

  • Remove skull pieces that broke off
  • Remove any objects, such as bullets
  • Remove part of the skull to ease pressure from swelling
  • Make holes in the scalp and skull to drain blood
  • Place a tube into the brain to drain fluid


Medicine may be given to manage symptoms. Examples are:

  • Antiseizure medicine
  • Prescription pain medicine


Recovery will include rehabilitation, such as physical and occupational therapy.


Most penetrating brain injuries are due to accidents that cannot be prevented.

Healthy bones and muscles may help prevent injuries from falls. This may be done through diet and exercise.


American Academy of Neurology 

Brain Injury Association of America 


Brain Injury Canada 

Ontario Brain Injury Association 


Barth J, Hillary F. Closed and penetrating head injuries. Saint Joseph’s University website. Available at: Accessed October 2, 2020.

Gunshot wound head trauma. American Association of Neurological Surgeons website. Available at: October 2, 2020.

Moderate to severe traumatic brain injury. EBSCO DynaMed website. Available at: . Accessed October 2, 2020.

National Institute for Health and Care Excellence (NICE). Head injury: assessment and early management. NICE 2017 Jun:CG176.

Traumatic brain injury and concussion. Centers for Disease Control and Prevention website. Available at: Accessed October 2, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 09/2020
  • Update Date: 05/21/2021