Head Trauma

Head trauma or head injury refers to any accidental injury to the head which often is associated with brain injury. Head trauma ranges from mild  to severe, potentially life-threatening injuries. Head trauma can occur in persons of any age and is a frequent reason for paediatric hospitalisation.

Causes

Head trauma may be caused by an accidental injury to the head, and is often associated with automobile accidents, falls, and sports injuries. The brain can be injured during head trauma either by bruising (contusions) or when the axons or long tendrils of the brain’s nerve cells are suddenly stretched and damaged by whiplash. Cerebral contusions commonly occur in the frontal and temporal lobes, where this portion of the brain crashes into the skull base which is not smooth and contains many spike like edges. Axonal damage (whiplash) is more likely to occur toward the center of the brain. Anything that fractures the skull can cause severe brain injury, in that bone can be pushed into the brain.

Terminology

Head trauma can be open (an object pierces the scalp (skin of the head) and skull) or closed (the skull may be at most fractured but nothing penetrates into the brain). Resulting brain injury can be focal or localized to a small area, or diffuse, covering a wide area. An intracranial haemorrhage refers to bleeding within the brain which may produces a haematoma.  Intracranial haemorrhage can be subdural, subarchnoid, extradural, or intraparenchymal, depending on what area of the brain experiences the haematoma. While most brain injuries occur at or near the point of impact, a countrecoup injury occurs on the opposite side of the brain. For example, if a person is hit in the forehead, the brain may be jolted backward and this rear area of the brain that slams against the skull can be injured. Patients with head trauma often experience a concussion, a brain injury that may result in altered consciousness or loss of consciousness mostly for short period and often has after-effects (sequelae).

Symptoms

Patients with head trauma should seek medical help. Severe head trauma is a medical emergency requiring immediate expert intervention. Symptoms of head injury are usually not needed for diagnosis and treatment, but include:

  • Loss of consciousness, even for just a few moments
  • Coma
  • Confusion
  • Drowsiness
  • Personality change
  • Nausea and vomiting
  • Seizure
  • Motor or sensory deficit (wakness or paralysis)
  • Headache

Patients with brain injuries may experience symptoms which seem to briefly resolve, only to recur later. A patient with a head injury who is “acting normally” may still be seriously injured.

Treatment

Mild head injury may require no medical treatment beyond monitoring and observation; such patients may be treated with a brief course of analgesics to help manage pain. More severe head injuries should be monitored and imaged by C.T. Scan or MRI brain. In some cases emergency neurosurgery may be required to relieve bleeding into the brain and reduce intracranial pressure. Some patients may be sedated or put into a medically induced coma with mechanical ventilation and insertion of a catheter-probe to measure continuously the intra cranial pressure, this help reduce intracranial pressure and allow the brain to heal. Hypothermia or cold treatments may also be used.

Head injuries are a broad category of medical emergency that require expert diagnosis and prompt, medically appropriate treatment. The Neuro Spinal Hospital offers such specialised care along with the latest imaging technologies and surgical techniques.

Prognosis

The prognosis for a head injury patients depends on the type and extent of injury, the care received, how quickly medical intervention occurred, and the patient’s overall health. Many patients make a full recovery from head trauma. In some patients, neurological deficits will occur following head injury; these may disappear with time. For patients with severe head trauma, long-term neurological monitoring may be necessary, even if the patient appears to have made a full or nearly full recovery. Unfortunately some patients with severe head injury may die or stay in coma for a long period and may become in vegetative state.

Conclusion

Head injury often results in injury to the brain, which can be a medical emergency. The Neuro Spinal Hospital offers expert diagnosis of head trauma and appropriate treatment, which may include imaging and monitoring, pain control, and, in some cases, emergency  neurosurgical operation or medically induced coma. Many patients with head trauma will make a full or nearly full recovery, but ongoing neurological monitoring may be prudent.