Introduction:
The skull protects the brain against trauma to a certain level, but when the potential force exceeds the tolerating capacity, it results in moderate to serious brain injury. Minor head injuries are common among all age groups due to falls, assaults, or road traffic accidents. Comparatively, minor injury recovers within a few days after hospitalization without permanent brain damage.
What Is a Concussion?
A concussion (temporary brain injury) is a traumatic brain injury that alters the function of the brain with or without loss of consciousness. A concussion can also affect memory, reflexes, speech, balance, and muscle coordination, which usually recovers within a short period.
What Are the Symptoms of a Concussion?
The most common symptoms of concussion are:
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Confusion.
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Headache.
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Blurred or double vision.
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Sensitivity to light.
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Dizziness.
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Nausea and vomiting.
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Memory loss.
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Altered smell and taste.
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Insomnia (sleeping disorder).
What Should a Person Do After a Head Injury?
Seek medical help when experiencing underlying conditions:
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Unbearable headaches.
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Had a history of brain surgery.
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Significant nausea and vomiting.
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Slurred speech.
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Loss of memory (cannot remember what happened immediately before or after surgery).
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Unconscious (partial or complete).
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Loss of muscle coordination.
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Inability to stand or walk.
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Bleeding from their ear.
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Seizure (sudden uncontrolled shaking of the body).
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Numbness in any part of the body.
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Problems with their vision or hearing.
What Will Be the Possible Risk Factor After a Head Injury and Concussion?
For minor head injuries and concussions, the symptoms last for several weeks. Neurosurgeons (experts in brain surgery) emphasize that some concussions are less dangerous and recover within a few days. Some may involve the following risk factors:
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Constant severe headaches.
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Amnesia.
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Abnormal behavior, including agitation, confusion, and drowsiness.
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Hematoma (blood clot in the organ or tissue).
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Seizure.
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Skull fracture.
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Abnormal neurological conditions like learning disabilities, brain tumors, autism(a developmental disorder that affects the cognitive, emotional, social, and physical health of the individual), neuromuscular disorder(affects the function of both muscles and nerves), and cerebral palsy (group of disorders affecting the movement, balance, and posture of the body).
How to Access the Severity of the Situation?
The severity of trauma is distinguished into four factors:
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Mild Head Injury Without Risk Factors: The patient remains active and responds to the command with normal motor function with or without pain.
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Mild Head Injury With Risk Factors: The patient is active and responds to the command with a localized pain that withdraws after removing external stimuli (pain experienced during physical touch). The risk factors involve headaches, nausea, vomiting, confusion, and drowsiness.
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Moderate Head Injury: The patient is partially active and responds only with repeated commands with pain on flexion and extension (motor action).
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Severe Head Injury: The patient is inactive or unconscious with major risk factors (skull fracture, seizure, brain hematoma, and neurological disorder).
What Is the Treatment Protocol for Head Injury and Concussion?
The treatment is implemented based on the severity of the injury and ‘glass coma score’ (scoring based on eye, verbal, and motor response on an individual for assessment of critical care; it ranges from 1 to 15 based on severity).
1. Treatment Protocol for Mild Head Injury Without Risk Factors:
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The glass coma score (GCS) is 15.
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After complete examination and investigations with no remarkable injury, the person remains physically active and is often discharged with analgesic medication (to treat pain).
2. Treatment Protocol for Mild Head Injury With Risk Factors:
- Glass coma score (GCS) is 13 to 14
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After complete examination and investigations, the patients are observed for four hours at 30-minute intervals for pulse rate, blood pressure, respiratory rate (breathing rate), pupil (eye movement), and limb power. The patient is discharged based on the capability of fluid intake along with anti-emetics (medicine for vomiting) and analgesics.
3. Treatment Protocol for Moderate Head Injury:
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Glass coma score (GCS) is 9 to 12
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After a complete examination and investigations, the patient is advised to get a CT scan (computed tomography) head for a definite diagnosis. Until then, the patient is under palliative treatment (symptomatic treatment) and also requires hospitalization for further observation.
4. Treatment Protocol for Severe Head Injury:
- The glass coma score (GCS) is less than 8.
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The patient is advised for an urgent head CT scan, and a cervical spine assessment is done, followed by incubation and ventilation.
5. Treatment Protocol for Concussion:
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The standard treatment protocol for concussion is plenty of rest with a thorough medical examination. At a later stage, some people may suffer from post-concussive syndrome (inability to concentrate, mood swings, headache, fatigue, dizziness, insomnia, and drowsiness) for several weeks to months. Patients with post-concussive syndrome are strictly advised to avoid any physical activity due to the risk of repeated concussions which may result in brain swelling, also known as a second-impact syndrome.
Follow-up: For mild to moderate injury, patients are advised to get a check-up within one to two weeks for evaluation of post-injury symptoms and improvement.
How to Manage Concussions in Sports Persons?
Once the athlete is diagnosed with a concussion, the sports protocol advises regular monitoring of recent concussions and the medical history of the player and temporary elimination from sports due to the high risk of second-impact syndrome (brain swelling). Re-entry into sports is only possible after getting a fitness certificate from a physician for better recovery.
How to Prevent Head Injury and Concussion?
Prevention is always better than cure. Hence following methods should be looked for:
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Make sure to use a helmet of the correct fit for maximum protection during sports activity and driving.
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Despite the major risk of trauma, headgear is recommended in martial arts and soccer. Often check for damage to headgear and other equipment while playing.
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Avoid using clothes that interfere with vision and sports.
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Wear a seat belt while driving or riding a car.
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Avoid drinking and driving.
Conclusion:
Unfortunately, many young people still lead a lifestyle that predisposes them to trauma through unprotected sports activity, and alcohol consumption while driving often predisposes them to head injury. However, with proper care and treatment, these risks can be minimized.
