Head Injury: How do you know if it’s serious?

Jul 30, 2017 Dr Zulfikar Bux, Features / Columnists

By Dr. Zulfikar Bux
Assistant Professor of Emergency Medicine

When you injure your head, there is always a risk of brain injury.
Our brain is our main control centre and we cannot function without it. Unfortunately, brain injury is

Dr. Zulfikar Bux

the leading cause of death, disability and seizures in patients with trauma worldwide.
Sometimes brain injury is not evident and may be missed, leading to lifelong complications or even death. This is especially true for patients with closed head injury where the effects of the trauma/ hit are more internal than on the outside.
A closed head injury happens when a person hits his or her head on a hard surface or when an object hits and hurts the head, but doesn’t go through the skull. Even though the object doesn’t go through the skull, parts of the head can still get damaged.
A closed head injury can cause:
* A broken bone of the skull or face
* Brain injury or swelling
* Bleeding in or around the brain

The most common causes of a closed head injury are falls, sports injuries, and car and bike accidents.
Some closed head injuries are mild. Another word for a mild brain injury is a “concussion.” Closed head injuries can also be severe and life-threatening.
Today we will discuss some facts about closed head injury to help you detect some subtle signs that may be present in a closed head injury and are signals of more serious internal injury.

WHAT ARE THE SYMPTOMS OF A CLOSED HEAD INJURY?

Symptoms depend on the type of injury a person has and how severe it is.
People with a mild closed head injury, such as a bump on the head, might not have any symptoms.
When a closed head injury does cause symptoms, it can cause:
* A headache
* Nausea or vomiting
* Swelling, bleeding, or bruising on the scalp
* Dizziness
* Confusion or memory problems
* Feeling tired
* Mood or behaviour changes
* Trouble walking or talking
* Seizures – Seizures are waves of abnormal electrical activity in the brain. They can make you pass out, or move or behave strangely.
* Passing out

A closed head injury that involves a broken skull or face bone can also cause:
* Bruising around the eyes or behind the ear
* Blood or clear fluid draining from the nose or ear
Symptoms can start right after a closed head injury, or a few hours or days later. Some people have symptoms that last a short time only. Other people have symptoms that cause long-lasting problems.

WILL I NEED TESTS?

It depends on your injury and symptoms. Your doctor will ask about your symptoms and do an exam. He or she will also ask questions to check your thinking.
If your doctor thinks you might have a serious injury, he or she might order an imaging test of your brain, such as a CT or MRI scan. These tests create pictures of your skull and brain.

HOW IS A CLOSED HEAD INJURY TREATED?

Treatment depends on your injury and how serious it is.
Usually, mild closed head injuries do not need treatment. But your doctor might recommend that someone watch you for 24 hours after your injury.
This person should watch for new symptoms or the symptoms listed above, and make sure that you can be woken up after you fall asleep.
Severe closed head injuries need to be treated in the hospital. Treatment can include:
* Medicines – Some medicines help prevent brain swelling. Others help prevent seizures.
* Surgery – If you have bleeding in or around your brain, or if your brain swells, you might need surgery.

WHEN SHOULD I VISIT THE DOCTOR?

After your closed head injury, you should be seen by a doctor if the following signs or symptoms are present:
* Your headache gets worse or it’s persistent
* You vomit repeatedly
* Your thinking or behaviour changes and you appear confused
* You can’t walk normally
* You have a seizure
* You have clear fluids draining from the nose or ears
* You have weakness or numbness in fingers and toes
* If the person watching you cannot wake you up
These may be signs of brain injury that needs further testing or treatment.
It is always better to be safe than sorry.
Protect your head by wearing a helmet if you are cycling or playing sports where the ball is hard.
Avoid being intoxicated, as it’s a common reason why people injure their head. In the event you or someone sustains a head injury, look out for the warning signs and do not hesitate to visit a doctor if any is present.