Which of the following is an acute sign of closed head trauma?

The correct answer is A. Memory loss.

Why A is correct (Memory loss):

Memory loss (amnesia) is a common and immediate (acute) sign of closed head injury, especially in concussions. It may include:

Retrograde amnesia (loss of memory before the event)

Anterograde amnesia (inability to form new memories)

NREMT-aligned trauma guidance states:

“Patients with head injuries may present with confusion or memory loss immediately after the event.”

This is considered an early indicator of brain injury.

Why the other options are incorrect:

B. Beck ' s Triad: Associated with cardiac tamponade (hypotension, JVD, muffled heart sounds), not head trauma.

C. Battle ' s sign: Bruising behind the ears indicating a basilar skull fracture, but this is typically a late sign, not acute.

D. Raccoon eyes: Periorbital ecchymosis also indicating a basilar skull fracture, and similarly a delayed finding, not immediate.

Key Concept:

Acute signs = occur immediately (e.g., confusion, memory loss, LOC)

Late signs = develop over time (e.g., Battle’s sign, raccoon eyes)

Exact Extracts:

“Early signs of head injury include confusion, disorientation, and memory loss.”

“Battle’s sign and raccoon eyes are late signs of basilar skull fracture.”

“Assessment should identify immediate neurologic changes following trauma.”