Head injury also known as head trauma or traumatic brain Injury is one of the most common type of medical emergency observed these days . Speaking Medically head injury is any trauma to scalp , skull , and brain...
Introduction
Head injury also known as head trauma or traumatic brain Injury is one of the most common type of medical emergency observed these days . Speaking Medically head injury is any trauma to scalp , skull , and brain .
Traumatic brain injury (TBI) can manifest in a variety of ways, from minor changes in consciousness to death. The most dangerous variety of TB a diffuse damage that involves the entire brain and cerebellum.
A significant public health issue, head trauma accounts for thousands of hospital admissions annually and costs the healthcare system billions of dollars.
The emergency room sees the bulk of patients with head trauma; the head injury is frequently accompanied by injuries to other organs. An inter-professional team that is focused on treating head trauma patients provides care for the patient.
Head injuries include :
- The most frequent type of injury is concussion, which causes the brain to shake.
- Scalp wounds
- Skull fractures
Causes leading to head injuries:
The main leading causes that lead to head injuries include the following :
- Motor vehicle related injuries (bike , cycle riding )
- Assaults involving blunt force trauma to head
- Car accidents
- Falling over head while walking /running
Because the skull shields the brain, the majority of these injuries are minimal. Some injuries are severe enough to require a stay in the hospital.Head injuries are more commonly observed in children adults upto 25 years of age.
The following sports-related activities result in the most brain injuries among people of all ages:
- Cycling
- Football
- Basketball
- Softball and baseball
- Riding powered recreational vehicles like go-karts, minibikes, and dune buggies
Contusions or brain haemorrhages can have other causes, such as:
- Long-term high blood pressure (in adults)
- Bleeding disorders
- Use of blood thinners or certain recreational drugs
Symptoms:
Head injury symptoms may appear immediately or may take hours or days to appear. The brain may strike the inside of the skull and become injured even if the skull is unbroken. The head may look fine, but problems could result from bleeding or swelling inside the the brain .
Head injuries may cause bleeding in the brain tissue or the layers that surround the brain . In case of severe accidents or fall from greater heights the spinal cord may also be injured . Some head injuries result change in brain function and this case is known as TBI i.e TRAUMATIC BRAIN INJURY . Concussion is an example of TBI
Concussion-like symptoms of a TBI include:
1.Confusion
2.Depression
3. issues with balance or vertigo
4.hazy or double vision
5.feeling dazed or sleepy
6.feeling lethargic or exhausted
7.Headache
8.No memory
9.Nausea
10.sensitivities to noise or light
11.sleep disruption
12.difficulty concentrating
13.difficulty remembering
Injuries to the head that may be more serious than a concussion and call for immediate medical attention include:
a)changes in pupil size
b) Drainage of a clear or bloody liquid from the mouth, nose, or ears
c) Stiff neck
d) persistent vomiting
e) swelling at site of injury
Concussion:
The perception of concussive injuries as mild TBIs without significant structural damage is common. Concussion occurs typically after direct head trauma, with subsequent acceleration and deceleration forces. Following a concussion, the victim often experiences varied degrees of brief altered mental status, ranging from mild confusion to genuine unconsciousness lasting a few minutes.
When two athletes collide or a player is struck in the head with a piece of athletic equipment, they both run the risk of suffering a concussion or another head injury.
Even "heading" the ball in soccer can result in a concussion.
Classification of head injuries/tbi:
clouding of awareness, which occurs when the brain's processing abilities are slightly impaired. Long-term memory is unaffected, even if the condition may last for several months and the patient may lose recent recollection.
Lethargy is a state of diminished attentiveness that makes it difficult to complete things that one would normally complete without any effort. The patient may become stimulated but then return to their inactive state afterward. Environment awareness is present.
Obtundation is a condition marked by lowered consciousness and alertness. The patient won't be aware of their surroundings but will respond to stimuli for a small period of time and only obey simple instructions.
When a patient is in a coma, they are unable to communicate clearly and must be awakened by painful stimuli.
When a patient is in a coma, they are unable to communicate clearly and must be awakened by painful stimuli. When the stimulus is stopped, the patient goes back to being inactive.
When a patient is in a coma, they are unable to react to any kind of stimulus.
Examination:
Patients who have suffered head trauma must have a CT scan.
There are two guidelines that have been externally validated for when to get a head CT scan following a TBI for individuals who are at low risk for intracranial damage.
It's crucial to realise that no patient's medical history or physical exam results can completely rule out the likelihood of intracranial injury in cases of head trauma.
Only the detection of foreign objects, gunshots, and stab wounds is done using skull x-rays.
Ways to recognise a head injury:
A person's life can be saved by becoming knowledgeable about major head injuries and basic first aid. Call 102 or your local emergency number right away if you have suffered a moderate to serious head injury.
If the offender commits any of the subsequent::
- becomes incredibly sleepy
- demonstrates inappropriate behaviour or uses illogical statements
- becomes quite headachy or stiff in the neck
- have a seizure
- has irregularly sized pupils (the black, center portion of the eye)
- not able to move an arm or a leg completely
- even momentarily loses
- repeatedly throws up
Steps to take in case of medical emergency:
- Verify the person's respiration, circulation, and airway. Start CPR and rescue breathing if necessary.
- If the patient is unconscious but breathing and heart rate are normal, assume a spinal injury.. By placing your hands on either side of the person's head, you can stabilise the head and neck.
- Prevent movement by keeping the head in alignment with the spine. Await medical assistance.
- If you don't see a skull fracture, firmly cover the wound with a clean towel to stop any bleeding. Be careful not to move the person's head if the damage is severe.
- Do not remove the cloth if blood seeps through it. Over the first cloth, place another.
- Do not put direct pressure on the area that is bleeding if you think there may be a skull fracture, and do not clean the wound of any debris. Use sterile gauze to dress the wound.
- Roll the person's head, neck, and body together while supporting the head and neck onto their side to prevent choking if they are about to or have already started vomiting.
- The spine, which is usually presumed to be harmed in the event of a head injury, is nonetheless protected by this. The first time following a brain injury, many kids puke. Though it might not be a concern, seek further advice from a physician.
- To reduce swelling, apply ice packs. Ice should be wrapped in a towel to prevent skin contact.
Hospitalisation is needed in case of:
- CSF leak
- Bleeding disorder
- Patient taking anticoagulation therapy or anti platelet therapy
- Patient has completely lost consciousness
Treatment and management:
Preventing subsequent brain damage is the main objective. The following can be done :
- Keep your airway and ventilation open.
- maintain the pressure of cerebral perfusion
- Keep secondary injuries at bay (by recognising and treating hypoxia, hypercapnia, or hypo-perfusion)
- Assess and prepare for higher ICP
- Consult a neurosurgeon right once if you have any intracranial mass lesions.
- Determine and address further diseases or injuries that pose a risk to your life. (if they exist)
There must be a considerably greater systemic blood pressure to balance the increasing intracranial pressure (ICP). The signs of a moderate to severe damage should be carefully monitored periodically.
A doctor might utilise X-rays to check for potential skull fractures and the stability of the spine. Sometimes the doctor will ask for a CT scan or an MRI to assess the severity of the damage.
For more severe wounds, surgery might be necessary to relieve pressure on the swelling.
Do not immediately order an X-ray for a youngster who has suffered a head injury. Keep a close eye out for any TBI symptoms that are age-appropriate, like confusion or a change in behaviour. Don’t give them medications, including aspirin, without advice from your doctors.
. Do not administer any drugs, including aspirin, to them without consulting your doctors.
The doctor might advise you to keep a close eye on the injured person if they send you home with them. That may involve waking the person every few hours to ask questions such as "What's your name?" or "Where are you?" to be sure the person is OK.
Be sure you've asked the doctor and understand what symptoms to watch for and which ones require immediate attention.
In addition, the FDA has approved the noninvasive device, called Q-Collar which can be worn by athletes to help prevent head injuries.
The C-shaped collar applies compressive force to the neck and increases volume to help reduce movement of the brain, which may occur because of hits to the head. The device may reduce specific changes in the brain that are associated with brain injury.
Precautions:
Take these safety measures:
1.A serious or heavily bleeding head trauma SHOULD NOT BE WASHED.
2. NEVER remove anything that is protruding from a wound.
3. A person should not be moved unless it is absolutely essential.
4. Even if the person seems confused, DO NOT shake them.
5. If you think you might have a serious head injury, DON'T remove your helmet.
6. DO NOT pick up a youngster who has fallen and shows signs of a head injury.
7. Within 48 hours of a significant head injury, DO NOT consume alcohol.
A serious head injury that involves bleeding or brain damage must be treated in a hospital.For a mild head injury, no treatment may be needed. However, call for medical advice and watch for symptoms of a head injury, which can show up later.
Your physician or health care provider will explain what to expect, how to manage any headaches, how to treat your other symptoms, when to return to sports, school, work, and other activities, and signs or symptoms to worry about. When it is safe to resume sports, both adults and children must abide by the doctor's or provider's directions.
Preventions:
Not every head injury is preventable. Simple actions like the ones listed below can help keep you and your child safe:
- When engaging in activities that could result in a head injury, always wear safety gear. These include seat belts, hard hats, and bicycle or motorcycle helmets.
- Recognise bicycle safety recommendations and abide by them.
- Don't drink and drive, and don't let anybody else drive you if you know or believe they've had alcohol in their system or are otherwise impaired
Outcomes:
Unfortunately, despite public education, many young people continue to live lifestyles that put them at risk for head injuries. Young people are still more prone to brain injuries because they frequently participate in high-risk sports, drink while driving, use illicit drugs, abuse alcohol, and text while driving.
Prognosis:
Following the doctor's or provider's recommendations regarding when it is safe to restart sports is crucial for both adults and kids. Even individuals who are released frequently still suffer from neurological or executive function problems. Some people need months-long speech, occupational, and physical treatment. The social worker should also inspect the house to make sure the disabled person has access to amenities and that it is safe. The morbidity of head trauma can only be reduced with such a collaborative effort.
