Which of the following statements about head injuries is/are false?

B. Head injury alone often produces shock

DISCUSSION: Head injuries cause the majority of deaths following automobile accidents, with rupture of the thoracic aorta the second most common cause of fatality. Head injury itself rarely produces hypotensive shock. It is only in the terminal phases of brain death that hypotension may be attributable to head injury alone. Therefore, hypotension in trauma patients must be assumed to be secondary to volume depletion or ongoing hemorrhage. An occult site of hemorrhage (chest, abdomen, pelvis, retroperitoneum, or extremities) must be strongly suspected and dealt with accordingly. A rapid and complete neurologic assessment is a crucial part of the initial assessment of all trauma patients. This initial exam gives an excellent indication of injury severity and prognosis. Since the ultimate outcome of a brain injury is dependent on adequate cerebral perfusion and oxygenation, adequate airway control, ventilation, hemorrhage control, volume restitution, and arterial oxygenation are crucial factors in the early management of head injuries.