Head Injury - Type of Head Injuries, Symptoms, Severity Assessment, and Treatment Modalities

Introduction:

Trauma is the most common cause of a head injury. Sometimes, it is a road traffic accident, a fatal fall, or when something hits or falls on one’s head. All these can cause possible harm to the skull, scalp, or brain itself. Based on the type of wound, it can be an open head injury where the skull bone is cut open or a closed head injury where the skull is intact, but the structures inside are affected. The impact of the trauma may cause injuries ranging from a minor bump or bruise to a deep open wound, fractured skull bones, or severe internal bleeding. Mild traumatic injuries to the brain pose no grave consequences. In contrast, severe traumatic brain injuries require immediate attention and medical assistance because they can cause long-term disabilities or death of the individual.

What Are the Symptoms of a Possible Head Injury Following Trauma?

Depending on the degree and impact of trauma, symptoms vary. Some symptoms arise right after the injury, whereas others develop after a while or maybe a few days after the traumatic incident.

First, let us look at the symptoms exhibited by each type of head injury:

• Concussion:

A concussion is caused by a fall or a blow on the head that tends to shake the brain within the skull a little bit. The resultant injury is a mild one. One might show the following symptoms:

• A bump on the head or a small cut on the scalp.

• Go unconscious momentarily and regain sense quickly.

• Stay confused and dizzy.

• Possible short-term memory loss and inability to focus.

• Drowsiness, nausea, and vomiting after head injury.

• Ringing in the ears and blurred vision.

• Disturbed sleep.

There are three concussion degrees. These concussion degrees are

• Grade 1: Mild concussion, which usually lasts for some time.

• Grade 2: Moderate concussion will be present for a long time, and the person can experience dizziness, confusion, etc.

• Grade 3: Severe concussion where there will be loss of consciousness for less than one minute.

• Grade 4: In this grade, the person will lose consciousness for over a minute.

Contusion:

It occurs when the brain is partly bruised, causing inflammation. There may be swelling inside, increasing the pressure inside the skull (intracranial pressure). This is going to cause:

• Increase in blood pressure.

• Dilated pupils.

• Low heartbeat and shallow breathing.

Skull Fracture:

With heavy impact trauma, the skull may fracture, with or without bruising the skin. One can recognize a skull fracture from the following symptoms:

• Pain in the area of the fracture with or without open wounds.

• Distinct swelling.

• Irregularity in the surface of the skull bone.

• Bruises behind the ear or around the eyes.

• Secretions oozing out of the nose or ears (blood or fluids).

Bleeding Inside the Brain:

Lacerations and crush injuries to the skull and brain may cause the breaking of blood vessels. Bleeding inside the brain (intracranial hemorrhage) is a life-threatening emergency that requires immediate care. When the blood vessels burst and fill the brain with blood, it applies pressure to the structures inside the skull. This blood may clot to form a big mass (hematoma). When there is apparent bleeding inside the brain, the following symptoms occur:

• Intense headache due to the increased pressure inside the head.

• Seizure attacks.

• Frequent nausea and vomiting after head injury.

• Partial weakness of the body and lethargy.

• One may gradually fall unconscious.

Shear Injury:

It is when the brain detaches from inside the skull due to the severe impact of the trauma. The brain tends to hit the inside walls of the skull, causing death and damage to numerous brain cells. The individual goes unconscious straight away and stays that way for a long time due to permanent damage to the nervous system.

Will There Be Vomiting After a Head Injury?

Vomiting after a head injury can be a sign of a skull fracture or subdural hematoma. Vomiting after a head injury is seen as a serious condition that needs immediate medical attention. There are many causes for vomiting after head injury; these are

• Migraine.

• Skull fracture.

• Subdural hematoma.

• Vestibular dysfunction.

How Is a Brain Injury Diagnosed?

All patients exhibiting signs of a head injury following trauma must be brought to the hospital without delay. First, the doctor will ask for a medical history and details regarding the trauma. Next, one should assess the severity of the injury by conducting several physical and neurological examinations. The doctor will evaluate features like eye movements, strength and muscle control, response to sensory stimulation, and more.

The following tests are performed:

• Assessing the Glasgow Coma Scale (GCS) - This test assesses 15 parameters indicative of possible brain damage affecting mental status. If the GCS score is high, one probably has only a mild injury. In comparison, a low GCS score is indicative of severe brain injury.

• Computed Tomography (CT) - Scan of the head to detect skull fractures, injury to the brain, internal bleeding, and development of swelling inside the brain.

• Magnetic Resonance Imaging (MRI)- Helps identify the extent of the injury and resultant damage to the brain in much more detail.

• X-ray - It can show the fracture line and area of impact to plan the treatment.

• Electroencephalogram (EEG) - It records the brain's electrical activity, which indicates brain function.

What Is the Mode of Treatment Following a Head Injury?

For mild traumatic head injuries, healthcare professionals observe the affected individual for a definite period of time. Doctors prescribe medications to relieve symptoms such as pain, headache, vomiting, etc. If the symptoms do not worsen over time, indicating further brain damage, one can proceed with normal routine activities.

Following is the usual plan of action following a head injury:

1. Routine wound care will be performed, including cold compression with ice packs, stitches, bandages for the wound, and antibiotic creams.

2. For those who have had a concussion, it is advised to rest and avoid physical exertion for a while until the brain recovers from the impact.

3. If severe traumatic injuries are identified during diagnosis, surgical intervention by a neurosurgeon is mandatory. The immediate action is to stop the bleeding and remove the blood clots formed inside the skull. This helps relieve the brain from increased intracranial pressure.

4. If necessary, the patient will be put under sedation aided by mechanical ventilation to assist breathing.

5. People who suffer long-lasting disabilities from a head injury may require prolonged medical follow-up and rehabilitation. In addition, depending on the type of disability, they may need physical, occupational, and speech therapies for effective improvement.

Conclusion:

For trauma-associated head injuries, time is critical. Any delay in seeking medical attention can advance the potential damage to the brain, resulting in total body paralysis or the death of the individual. Even though one does not exhibit severe symptoms in the early hours after trauma, the chances of serious injury cannot be ruled out. In many cases, conditions worsen over time. This is why early intervention can save lives and avoid long-term consequences like mental and physical disabilities.