Head injury signs and symptoms and basic first aide

More than 500,000 people suffer a head injury each year in the United States. The majority of these injuries are mild in nature and don’t require hospitalization. A head injury is trauma to the head causing bleeding, stretching, tearing or swelling of the brain tissue or scalp. Head injuries occur as the result of fall, assaults, bicycle accidents, occupational accidents, traffic accidents, sports injuries and bullets. They’re more likely to occur in males ages 15-24 and the elderly. When head injuries occur in children under two abuse is often suspected

Head injuries are classified as open or closed. An open head injury includes penetrating wounds such as bullet wounds and blunt trauma that has fractured the skull. An open head injury generally requires surgery to remove the object or repair the fractured skull.

Closed head injuries occur from blows to the head without an open skull fracture, as well as acceleration and deceleration injuries such as you’d see in sudden stops causing the head to whip forward and back again. In these injuries the force of the sudden stop causes the brain to hit the boney case of the skull and bruising, bleeding, and swelling can occur. This type of injury can be seen in motor vehicle accidents and fall.

The majority of head injuries such as scalp lacerations and mild to moderate trauma are easily repaired or recover on their own over a few weeks. A concussion which is the jarring or shaking of the brain caused by motor vehicle accidents and falls can sometimes take up to a year to totally recover. Contusions to the brain are bruises to the brain tissue. Hematomas are bleeding into the brain which causes a clot formation.  Hematomas will sometime have to be evacuated or removed if they are causing too much pressure on the brain. Increased intracranial pressure can occur from bleeding or swelling of injured brain tissue in the ridged boney skull. This can require immediate surgery to relieve the pressure and prevent brain damage.

The brain is covered by three Dura or meninges which line the brain inside the skull and spinal column. Bleeding is classified based on which Dura it occurs under. For example a subarachnoid bleed is one in which bleeding is under the arachnoid meninge.

Symptoms of a head injury can include the following:

1) Headache

2) Sleepiness

3) Confusion

4) dilated pupils or pupils of different sizes

5) Seizures

6) Vomiting

7) Weakness

8) Numbness

9) Confusion

10) Irritability and emotional outburst unusual for the person

11) Memory loss

12) Loss of consciousness

Any head injury that result in loss of consciousness, confusion, or new onset seizures should be followed by a doctor.

General first aide fro a suspected head injury include stabilizing the head by holding it with both hands, pressure to any bleeding and ice. If there is an impaled object, do not try to remove it.

Sever head injuries are often associated with injuries to the neck. If not absolutely necessary, don’t move the patient. Movement can cause greater injury to the spine if a fracture is present. Keep the patient still, stabilize their head and call for help.

If you suspect, or it is obvious the skull is fractured do not apply pressure as this can increase pressure on the brain.

Symptoms of head injury can develop over hours and can be subtle. A CT scan may not show some types of injuries such as microscopic tears. It’s wise to wake a person suspected of having a head injury up every three hours for the first 24 hours after injury and make sure they can answer simple questions.

Most head injuries recover on their own over a few weeks and their prognosis is good. Major head injuries can take as long as five year to recover and can be devastating in regards to permanent disability.