Head Injury (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Head injury facts
- Head injury introduction
- What are the causes of head injury?
- What are the symptoms of a head injury?
- What is the Glasgow Coma Scale?
- When should I contact a doctor about a head injury?
- How is a head injury diagnosed?
- How is a head injury treated?
- What is the prognosis for a head injury?
- How can a head injury be prevented?
- What about a head injury in infants and young children?
- Find a local Doctor in your town
What are the causes of head injury?
By definition, trauma is required to cause a head injury, but that trauma does not necessarily need to be violent. Falling down a few steps or falling into a hard object may be enough to cause damage. Motor vehicle crashes account for about 17% of traumatic brain injuries, while 35% are from falls. The majority of head injuries occur in males.
Penetrating head injuries describe those situations in which the injury occurs due to a projectile, for example a bullet, or when an object is impaled though the skull into the brain.
Closed head injuries refer to injuries in which no lacerations are present.
The brain may also be injured without a direct blow to the skull. The head sits on the neck allowing it to shake, causing the brain to slosh inside the skull and become injured.
What are the symptoms of a head injury?
The symptoms of head injury can vary from almost none to loss of consciousness and coma. As well, the symptoms may not necessarily occur immediately at the time of injury. While a brain injury occurs at the time of trauma, it may take time for enough swelling or bleeding to occur to cause symptoms that are recognizable.
Initial symptoms may include a change in mental status, meaning an alteration in the wakefulness of the patient. There may be loss of consciousness, lethargy, and confusion.
Head injury symptoms may also include:
- difficulty tolerating bright lights,
- leaking cerebrospinal fluide from the ear or nose,
- bleeding from the ear,
- speech difficulty,
- difficulty swallowing, and
- numbness of the body.
Other symptoms may be more subtle and include:
- difficulty concentrating and thinking, and
Late signs of significant head injury and raised pressure within the brain and skull include a dilated pupil, high blood pressure, low pulse rate, and abnormal breathing pattern.
Coma may be present if the patient doesn't awaken completely and is defined as a prolonged episode of loss of consciousness. There are different levels of coma and the Glasgow Coma Scale is one way of measuring its depth.
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