Final answer:
After a significant closed head injury, patients may develop pupillary abnormalities alongside hypertension due to the activation of the sympathetic nervous system and the body's attempt to maintain cerebral perfusion through Cushing's reflex.
Step-by-step explanation:
Patients with significant closed head injuries often have pupillary abnormalities and C) hypertension. When there is a closed head injury, various autonomic disturbances can occur due to the disruption of the neural pathways responsible for regulating blood pressure. The brain's response to injury includes the release of stress hormones, such as catecholamines, which can increase blood pressure. Additionally, the body may react to intracranial pressure changes that accompany head injuries by increasing systemic blood pressure to maintain cerebral perfusion, a phenomenon known as Cushing's reflex. Hypertension in this context is a compensatory response to sustain blood flow to the brain.
Patients could also experience tachycardia due to the same sympathetic nervous system activation that leads to hypertension. Paralysis or paresthesia may also be present if the head injury has caused direct nerve damage, but hypertension is a more direct response related to autonomic dysfunction following a closed head injury.