What Is Head Injury?
Traumatic brain injury, or more commonly called “head injury”, is a broad term that describes a variety of injuries and damage to the scalp, skull, brain and underlying tissue and blood vessels in the head.
Almost everyone in his or her lifetime sustain some form of trauma to the head. Elderly, babies and those with problems such as alcohol abuse, anti-coagulants therapy are especially prone to serious consequences after a head injury. In Singapore, head injury is the leading cause of disabilities and deaths in adults under 40 years of age. As a result, it has significant impact on the brain-injured patient, family and society.
Types of Head Injury
Head injury can be mild-to-severe in nature, and damage to the brain may occur immediately at the time of injury, or develop after the injury due to swelling or further bleeding. The common types of head injury include:
Signs and Symptoms
Varying degrees of symptoms including temporary or permanent loss of consciousness, nausea, vomiting, headache, giddiness, and loss of memory may appear associated with the severity of the head injury. The signs and symptoms of a head injury may occur immediately or develop slowly over several hours to days. Even if no serious injury is found, careful watching with a responsible adult either at home or hospital must occur in the first 24-48 hours after the injury.
For the 1st 24 hour after a head injury, the person SHOULD NOT:
Call for help or go to the emergency department if:
In Singapore, head injury occurs most commonly after motor vehicle accidents, falls at home or at work, acts of violence, sports and recreational injuries.
X-ray may be performed to detect any fracture. CT scan of the brain may be ordered if the doctor thinks that there are risks of acute bleeding that can cause life-threatening problem. The Glasgow Coma Scale (GCS) based on the sum of scores in 3 areas of assessment: Eye opening, verbal and motor response, is a tool frequently used in hospitals to grade the severity of the head injury that influences treatment decisions and outcomes.
Severity of head injury can be classified as:
Treatment is individualised, depending on the degree and extent of injuries. It ranges from observation for signs of worsening such as drowsiness, increasing headache or giddiness (minor head injury) to removal of the blood clot in the brain to relieve the pressure in the brain (cause by the blood clot) or insertion of a brain pressure monitor (severe head injury). Treatment for most minor head injuries includes symptom relief and adequate rest.
Outcome and Complications
This depends in the type, location and degrees of injury. People with a minor head injury may have concussion syndromes such as slight headache, giddiness, easily tired, decreased concentration etc that may persist for a while, but most recover with no permanent problems. After a severe head injury, one-third make good recovery, one-third is left with varying degrees of disability, while the rest do not survive.
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