Head injuries are fairly common and occur at a rate of over 1 million per year in the United States. Approximately 500,000 of those cases are severe enough to require treatment in an emergency room. Serious head injury results in death nearly 35% of the time and results in permanent disability in 50% of patients. The incidence of head injury is highest among those over the age of 75 mostly as a result of falling. Young adults between the ages of 15 and 24 make up the group with the second highest rate of brain injury mainly due to motor vehicle accidents. Head injury can occur any time the head is hit by another object or when the head slams into another object and for reporting purposes the injuries are generally classified as being caused by a fall, vehicle accident, sports injury, assault, strike by an object, and war injury.

All head injuries should be taken seriously, even if they appear mild at the time. Damage to the brain can sometimes be difficult to determine right away as the brain may have a slow bleed or take a period of time to swell to the point that symptoms can be observed.

There are four types of head injuries. These are concussion, contusion, fracture, and hematoma. A concussion is a jarring injury and usually causes the person to pass out and feel dazed. A concussion is also known as a shearing head injury because trauma can be done to the cells as they are sheared or jarred yet there is no obvious external damage. A contusion is a little more serious and is an actual bruise on the brain which means there is bleeding and swelling inside the skull. A skull fracture is when the skull itself cracks. The fracture can be just a slight crack or can be severe enough to send shards of bone deep into the brain which causes further brain trauma. A hematoma is a bump on the head which results from the collection of blood and clots which is a sign of bleeding inside the skull.

The human skull is made up of 8 bony plates and protected by an outer layer of hair, skin, fat, and muscle. Inside the skull, the brain floats in a pool of cerebrospinal fluid which is encased by connective tissue and membranes. This all works together to act as a shock absorber so the brain is not damaged by minor blows or sudden jarring movements.

An open head injury occurs when the skull or another sharp object pierces the brain and causes damage. A closed injury happens as a result of a severe jarring impact which causes the brain to slam against the inside of the skull. This can cause bleeding, swelling, and bruising.

Symptoms of a brain injury include loss of vision, nausea, loss of balance, listlessness, headache, memory loss, difficulty concentrating, and abnormal behavior. These symptoms can linger for weeks or even for several months if the injury is severe. A person who has had a head injury should be monitored closely and may even require hospitalization and an MRI scan. The person should be quizzed periodically to check memory and thinking ability. Symptoms that require immediate medical attention include change in pupil size, severe nausea, numbness or weakness of the arms or legs, fluid or blood draining from the ears or nose, seizures, or a sudden change in behavior.

Initially, treatment for a head injury includes basic first aid. Try to keep the injured person still. Don’t move him unless he is in a life threatening position. Attempt to stop bleeding by applying pressure unless a skull fracture is suspected. Do not apply pressure on a fractured skull. Observe the person constantly and watch for changes in alertness, breathing, and pulse. Begin CPR if indicated.

After being taken to an emergency room, the patient may require surgery to repair the skull and brain tissue. Drugs may be administered to slow the bleeding and swelling. Areas of the brain which are seriously damaged or destroyed in a head injury will most likely be damaged for life. The person may be able to regain some degree of normal functioning after going through rehabilitation which retrains the brain.

Rehabilitation after brain injury includes cognitive retraining exercises which work in a manner similar to rebuilding a weak muscle. This type of therapy includes playing games and working puzzles to exercise the brain. Speech therapy may also be indicated if damage has been done to the speech area of the brain. Physical therapy will also be used to strengthen weakened muscles and retrain the brain to walk and co-ordinate movements. Occupational therapy is useful for helping the individual learn adaptive techniques to compensate for skills permanently lost.

Due to the serious nature of a head injury, prevention is of utmost importance. Wear a helmet when riding a bicycle or motorcycle and wear a seat belt when driving or riding in a motor vehicle.


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Published November 17, 2011 by