In blunt head trauma, which statement is true?

• A. Dura is lacerated
• B. There is no impact to the skull
• C. There is immediate brain herniation
• D. Dura remains intact

Answer: (C)

When blunt head trauma is severe, the brain can rapidly swell or bleed inside the skull, quickly raising intracranial pressure. If this pressure becomes high enough, brain tissue can be squeezed and pushed (herniate) through natural openings or across structures like the tentorium or foramen magnum. That rapid shift of brain tissue is a dangerous, life-threatening event and can occur immediately after the injury in serious cases, which is why this statement is considered true in this context.

Note that the dura isn’t guaranteed to be torn in blunt trauma—dura can remain intact in many cases, and skull impact with or without fracture can still cause intracranial pressure changes. The chance of immediate herniation depends on how quickly mass effect develops, which is why it’s a hallmark of severe blunt head trauma requiring urgent attention.