Head Injury

Injury to the head can happen as a result of accidents, sports injuries, assaults, or falls. Most people will have a head injury at least once in their lives, although few are severe enough to go in to hospital. However, head injuries do account for 1% of all deaths in the UK, with half of all fatal head injuries caused by traffic accidents.

What sort of damage can be caused by an injury to the head?
Minor head injuries usually just involve the scalp of the head or the skull – even when there is a skull fracture, the brain itself may not be damaged in any way. Conversely, quite severe brain damage can be caused by blow which shakes the brain, even when there is no external signs of injury. Blows that injure the brain can cause extensive bruising and bleeding of brain cells, often causing tissue death and, therefore, brain damage. Other types of head injury include infection (such as happens when foreign matter enters a wound in the head) and inflammation (which is particularly common following bullet wounds).

What are the symptoms?
Minor head injuries:
* Headache – generally gone by the following day.
* Concussion – may cause confusion, dizziness, dazedness, and blurred vision, sometimes for a few days.
* Unconsciousness – usually for just a few minutes. Should be checked by a doctor.
* Bleeding from surface skin only – should be checked by a doctor.
* Vomiting – being sick once is not usually a very serious sign, but the person should be checked by a doctor to be on the safe side.

The symptoms of more severe head injuries may include:
* Unconsciousness – for longer than a few minutes. The more serious the injury, the longer the period of unconsciousness tends to be.
* Drowsiness – most people will feel a little drowsy and peculiar following a bang on the head, but slurring speech and progressive drowsiness indicates there may be a serious problem.
* Amnesia – loss of memory, usually of events just prior to, or just after, the accident, but can be of a longer period. Especially likely if the skull has been fractured or following loss of consciousness for more than a few minutes. The more serious the injury the more profound the amnesia tends to be. Anyone who has any amnesia following a head injury should be checked by a doctor.
* Continual vomiting – get medical assistance immediately, especially if combined with increasing drowsiness.
* Pupils of unequal sizes, double vision – get medical assistance immediately.
* Clear fluid from ear or nose – get medical assistance immediately.
* Soft boggy area on head – get medical assistance immediately.
* Seizure – sometimes the person may have a fit after a head injury. Most common in children. Person should be checked by a doctor asap.
* Muscular weakness, paralysis, or loss of sensation – following a severe head injury, the person may experience problems in other areas of his or her body. Anyone who experiences anything different about other areas of his or her body following a head injury should be checked by a doctor asap.

What about head injuries in babies?
A baby’s head is much heavier and larger in proportion to its body than the head of an older child or adult, and their necks are much weaker. Consequently head injuries can occur more easily and are more likely to be serious. Babies who suffer head injury often behave differently to older people. Signs and symptoms to look out for include:

* Raised fontanelles – the “soft spots” on the top of the skull may become raised and water-logged, tense, even hard. Very serious sign. Get medical assistance immediately.

* May become unconscious – if lasts for more than a few seconds, call an ambulance.

* Pupils of unequal sizes – get medical assistance immediately.

* Clear fluid from ear or nose – get medical assistance immediately.

* Soft boggy area on head – get medical assistance immediately.

* Peculiar, high-pitched, persistent cry – different from the usual cries. May be impossible to sooth. Should be checked by a doctor asap.

* Thrusting the head backwards – the neck is stiffening. Should be checked by a doctor asap.

* Seizure – fits are quite common in babies following a head injury. Should be checked by a doctor asap.

* Persistent vomiting – not a serious sign on its own, but if occurs together with any other symptom above, it could be serious and so you should get medical assistance immediately.

What should you do?
If you are in any doubt about the seriousness of a head injury, call for medical assistance – it is always better to be safe than sorry. Brain damage can have a slow beginning following a head injury, so monitor the person for any signs or symptoms over the following 24 to 48 hours. More specific first aid includes:
* Head wound – stop any bleeding by placing a sterile dressing over the wound and lightly holding or bandaging it in place. If there is an object sticking out of the wound, NEVER remove it – you could cause further damage. Cover the area around the object with a sterile dressing – NEVER put any pressure on to the object itself.
* Loss of consciousness – lie the person down with his or her head and shoulders raised slightly. Keep calling the person’s name or asking him or her if they are all right or can hear you. Gently shake the person’s shoulder from time to time. Don’t give the person anything to eat or drink – they are likely to choke. Monitor any response and be prepared to do mouth-to-mouth resuscitation if he or she stops breathing. If the tendency to lose consciousness is getting worse or consciousness is lost for more than a few minutes at a time, call an ambulance.
* Drowsiness – increasing drowsiness can be serious. If the person does fall asleep, wake him or her up at regular intervals (even in the middle of the night) to check that they respond as normal. If you can’t wake the person or suspect that something isn’t quite right, call an ambulance.
* Vomiting – if the person is sick or looks like he or she might be sick, gently roll them over on to their side in to the recovery position. The recovery position is when the person is lying on his or her side, with the lower leg stretched out and upper leg bent so the knee stops them rolling forward. The lower arm is bent up so the back of the hand rests on the floor and the upper arm is crooked so that the back of that hand is supporting the face.
* Clear fluid – if there is clear fluid coming from the ear or nose, call an ambulance immediately. Then lightly bandage the area with a soft, clean pad and then turn the person so the side that is leaking is downwards.

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