head injuryImages (Click to view larger image)
concussion, injury to the head, closed head injury, brain injury, traumatic brain injury
A head injury is defined as any trauma to the head that may or may not permanently injure the brain.
What are the signs and symptoms of the injury?
Symptoms of a head injury may include one or several of the following:
What are the causes and risks of the injury?
There are many possible causes for a head injury. Some common causes are bicycle accidents, automobile accidents, falls, and work-related injuries. Contact sports, especially football, are another common source of head injury. Other sports that place a person at risk for head injuries include:
Head injuries are more common in an individual with:
- ice hockey
- almost any other contact sport
What can be done to prevent the injury?
- an altered mental state as a result of drugs or disease
- difficulty walking because of arthritis, leg injury, or neuromuscular disease
- loss of balance or poor co-ordination from ageing or disease
Sports safety guidelines should be followed for children, adolescents, and adults. Helmets and seat belts are especially important in the prevention of head injuries.
Adults who have difficulty walking should use the proper equipment. Canes, crutches, walkers, or wheelchairs can lower the risk of falling. Homes should also be checked to see what devices are needed and what risks can be eliminated.
How is the injury recognised?
A head injury can be diagnosed by a healthcare professional with a standard neurological examination and complete history. An EEG, or electroencephalogram, may be ordered to look for abnormalities in the brain waves.
Tests such as a cranial CT scan, X-ray, and cranial MRI may also be used to determine the amount of damage to the brain. Often, all tests will be normal because the injury is not severe enough to detect.
What are the treatments for the injury?
Most head injuries require some first aid. The following steps are important when using first aid for a head injury:
The emergency medical system should be contacted at once if:
- The first thing to check is a person's airway and breathing. If necessary, begin CPR, or cardiopulmonary resuscitation, right away.
- Always consider a possible spinal cord injury when there is an injury to the head, especially if the person is unconscious. Support the head and neck, keep the head in line with the spine, and prevent movement.
- Try to stop any bleeding by applying direct pressure to the wound with a clean cloth.
- If there is a possible skull fracture, do not place too much pressure on the site of bleeding. Do not try to remove any objects from the wound. Cover the wound with sterile gauze and get medical help immediately.
- If the wound is not deep, wash it with soap and warm water and let it dry.
- If there is no suspected spinal cord injury, try to turn the head of a vomiting person to one side to prevent choking.
Some important safety measures include:
- there is severe bleeding
- there are many facial cuts
- there is a change in the person's level of consciousness
- the person is having trouble breathing
- a spinal cord injury is suspected
What are the side effects of the treatments?
- Avoid removing a helmet from a person who may have a serious head injury. Leave the helmet in place and allow a healthcare professional to remove it.
- Avoid washing a head wound that is very deep or bleeding heavily.
- Refrain from removing any objects that are sticking out of a wound, especially if they are going very deep into the wound.
- Avoid moving the person unnecessarily. Avoid shaking the person if he or she seems dazed or has a decreased level of consciousness. The person may have a spinal cord injury. The spinal cord may be further injured by movement.
- Avoid picking up a child or any other person who has fallen and has signs of a head injury.
It is important to avoid worsening of a spinal cord injury while treating the head injury. Significant airway swelling caused by other injuries to the face is another problem. It is important to keep checking the airway and the person's breathing.
What happens after treatment for the injury?
After treatment for a minor head injury, the person will generally be at home. Follow-up care includes:
Serious head injuries may require rehabilitation by a team of doctors, nurses, physiotherapists, occupational therapists, speech therapists, and psychologists.
- applying ice to areas of swelling
- using over-the-counter pain medication, such as paracetamol, as needed. Aspirin should be avoided because it interferes with normal blood clotting.
- following the doctor's instructions about rest and vigorous activity
- avoiding alcohol for at least 2 days after the head injury
- reporting any new or worsening symptoms to the doctor
Author: James Broomfield, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request
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