HEAD INJURY

General Information

DEFINITION--Injury to the head, with or without unconsciousness or other visible signs. Head wounds may be "open" or "closed" depending on the nature of the injury.

BODY PARTS INVOLVED--Head.

SEX OR AGE MOST AFFECTED--Both sexes; all ages, but most frequent in young males.

SIGNS & SYMPTOMS--

Depends on the extent of injury. The presence or absence of swelling at the injury site is not related to the seriousness of injury. Signs and symptoms include any or all of the following:

• Drowsiness or confusion.
• Vomiting and nausea.
• Blurred vision; pupils of different size.
• Loss of consciousness--either temporarily or for long periods.
• Amnesia or memory lapses.
• Irritability; headache.
• Bleeding of the scalp, if the skin is broken.

CAUSES--Injury. The worst injuries usually result from motor-vehicle accidents.

RISK INCREASES WITH

• Excess alcohol consumption.
• Contact sports, especially football or boxing.
• Seizure disorders.
• Falls.
• Bicycle or motorcycle riding without a helmet.

HOW TO PREVENT

• Don't drink or use mind-altering drugs and drive.
• Wear protective headgear for contact sports and cycling.
• Use your auto seat belt always. Place young children in safety car seats.
• Don't leave small children unattended in high chair, stroller, buggy or walker.
• Make sure ladders are in good condition.
• Make your home as safe as possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory studies of blood and cerebrospinal fluid.
• X-rays of the skull and neck.
• CT scan (See Glossary) of the head.

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's treatment.
• Hospitalization for observation, if signs and symptoms are severe.
• Emergency surgery to relieve skull pressure.

POSSIBLE COMPLICATIONS

• Bleeding under the skull (subdural hemorrhage and hematoma).
• Bleeding into the brain.
• Permanent disability or death.

PROBABLE OUTCOME--Usually curable with early recognition of danger signs and medical treatment. Patient is normally able to return home after recovery; some may require time in a rehabilitation facility.

How To Treat

GENERAL MEASURES--

• The extent of injury can be determined only with careful examination and observation. After a doctor's examination, the injured person may be sent home, but a responsible person must stay with the person and watch for serious symptoms. The first 24 hours after injury are critical, although serious after-effects can appear later (up to 6 months after the injury).
• If you are watching the patient, awaken him or her every 2 hours for 24 hours or as recommended. Report to the doctor immediately if you can't awaken or arouse the person. Report also any of the following: Vomiting. Inability to move arms and legs equally well on both sides. Temperature above 100F (37.8C). Stiff neck. Pupils of unequal size or shape. Convulsions. Noticeable restlessness. Severe headache that persists longer than 4 hours after injury. Confusion or disorientation.
• See Resources for Additional Information.

MEDICATION--

• Don't give any medicine--including non-prescription acetaminophen or aspirin--until the diagnosis is certain.
• Your doctor may prescribe anticonvulsants.

ACTIVITY--The patient should rest in bed until the doctor determines the danger is over. Normal activity may then be resumed as symptoms improve.

DIET--Full liquid diet (see Appendix) until the danger passes.

Call Your Doctor If

• You or a family member has symptoms of a head injury or observe them in someone else.
• After an injury, you observe any of the symptoms discussed in General Measures.